One Picture One Diagnosis-27

Deba P Sarma, MD Omaha

M 39, scalp nodule, 3 cm

Diagnosis: Skin, scalp, biopsy: - Cylindroma

Dermal cylindroma
Clinical: Sex: mostly female. Location: mostly scalp. Slow-growing, sometimes painful solitary pink or red dermal nodule averaging 1 cm in size. Familial cases are associated with multiple tumors. Such cases may also be associated with facial trichoepitheliomas, and eccrine spiradenomas, called autosomal dominant Brooke-Spiegler syndrome (familial cylindromatosis or turban tumor syndrome). Pathologic features: -Presence of numerous scalp lesions is called turban tumor. -Non-encapsulated dermal tumor not connected to the overlying epidermis. -Composed of numerous lobules of epithelial cells arranged in a jigsaw or mosaic pattern. -Prominent red basement membrane-like structure encircles the tumor lobules. -Each lobule shows a peripheral lining by dark basaloid cells and an inner larger and paler zone of cells. -Nodular deposits of red material within the lobules as well as focal well-formed ducts. -This is a common adnexal tumor of eccrine origin.