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digital papillary adenocarcinoma

Friday 20 September 2019

Aggressive digital papillary adenocarcinoma ; digital adenocarcinoma

PO

Definition : Aggressive digital papillary adenocarcinomas are rare malignant tumors often located on the digits of the hand. Due to lack of pain, slow growth, and an inconspicuous appearance, diagnosis is often missed or delayed.

Digital papillary carcinoma (DPC) is a rare, slow growing, malignant tumor with eccrine differentiation that occurs predominantly in digits. This tumor was originally classified as a benign neoplasm; aggressive digital papillary adenoma (ADPA) was first described by Helwig in 1979. In 1987, Kao et al. classified ADPA and aggressive digital papillary adenocarcinoma (ADPAca) based on differences in histologic findings.

Images

- https://twitter.com/TheCats33851341/status/1235706775711539200

Microscopy

- multinodular tumor
- well circumscribed nodules in dermis and superficial subcutis
- compact architecture and cystic architecture
- papillary structures, tubular structures or ductal structures
- two cell layer (myoepithelial cells )
- fused glands / lined by cuboidal cells with myoepithelial cells at the periphery
- solid area
- focal necrosis
- increased mitoses
- sheet-like growth pattern
- focal squamous differentiation
- small nest
- lymphatic invasion

- +/-

- tumor cells

Etiopathogeny

- HPV42

Differential diagnosis

- hidradenoma
- papillary eccrine adenoma
- apocrine hidrocystoma / apocrine cystadenoma
- microcystic adnexal carcinoma
- hidradenocarcinoma
- epithelial myoepithelial carcinoma / adenomyoepithelial carcinoma

- glandular architecture

  • metastatic adenocarcinoma

Open references

- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4386778/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4284491/