Announcing the new book by DermNet NZ

Download a FREE sample chapter

DOWNLOAD NOW

Hidradenoma papilliferum pathology

Author: Dr Harriet Cheng, Dermatology Registrar, Waikato Hospital, Hamilton, New Zealand; Dr Duncan Lamont, Pathologist, Waikato Hospital, Hamilton, New Zealand; A/Prof Patrick Emanuel, Dermatopathologist, Auckland, New Zealand, 2013.

Hidradenoma papilliferum, also called papillary hidradenoma, is benign tumour arising from apocrine glands (see sweat gland lesions). The lesion is a small solitary dermal or subcutaneous nodule, most commonly on the vulva.

Histology of hidradenoma papilliferum

Hidradenoma papilliferum is a well-circumscribed dermal nodule, usually without connection to the overlying epidermis (figure 1). Tubules and broad, elongated fronds form an arborizing pattern and are lined with a double-layered epithelium (figures 2, 3). The inner layer is comprised of cuboidal myoepithelial cells and the outer is tall columnar apocrine cells with a pale eosinophilic cytoplasm, which may demonstrate decapitation secretion. Larger fronds may have a fibrous core. Fibrous tissue surrounding the tumour may be compressed to form a pseudocapsule.

Special studies of hidradenoma papilliferum

None are generally needed. Epithelial cells express keratin, EMA and CEA. GCDFP-15 (a marker of apocrine differentiation) is usually positive. Oestrogen, progesterone and androgen receptors may be positive. Myoepithelial cells express S-100 and smooth muscle actin. PAS positive granules are evident in the apices of apocrine cells.

Differential diagnosis of hidradenoma papilliferum

Syringocystadenoma papilliferum: Differentiating features of this crusted lesion include continuity of the lesion with surface epithelium and a prominent plasma cell infiltrate of the fibrous cores.

Malignant variant with intraductal carcinoma: Extensive infiltrative growth pattern with prominent mitotic activity and nuclear polymorphism.

Adenocarcinoma: Lacks a myoepithelial layer, shows marked nuclear atypia and an infiltrative growth pattern.

Related information

Make a donation

Donate Today

Help us to update and maintain DermNet New Zealand

Submit your images

We are expanding our image library

Contact us

History of DermNet NZ

Watch Dr Amanda Oakley presenting 'The History Of DermNet NZ' at The International Society Of Teledermatology.

Subscribe to our mailing list

* indicates required
DermNet NZ Newsletter