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Adenomatous eccrine metaplasia--a novel reaction pattern
Claudine Yap Silva1, Meera Mahalingam
1Department of Dermatology, Dermatopathology Section, Boston University School of Medicine, Boston, MA 02118, USA.
The American Journal of Dermatopathology
|December 27, 2011
Summary
Atypical adenomatous metaplasia of eccrine glands is observed in 17% of biopsies. This metaplasia is more common in epithelial neoplasms like squamous cell carcinoma (SCC) and basal cell carcinoma, suggesting a tumor-induced reaction.
Area of Science:
- Dermatopathology
- Oncology
- Surgical Pathology
Background:
- Atypical adenomatous metaplasia of eccrine glands was incidentally observed in a squamous cell carcinoma (SCC) biopsy.
- The frequency and lineage specificity of this metaplastic change in various skin neoplasms were not well-established.
Purpose of the Study:
- To determine the prevalence of adenomatous metaplasia in excisional biopsies.
- To investigate if this metaplasia is associated with residual tumor and if it is lineage-specific.
Main Methods:
- Retrospective review of 201 excisional biopsies.
- Analysis of adenomatous metaplasia presence and association with residual tumor in basal cell carcinoma, SCC, and nevomelanocytic neoplasms.
Main Results:
- Adenomatous metaplasia was found in 17% of cases (35/201), with residual tumor in 19 cases.
- Metaplasia was more frequent in basal cell carcinoma (16%) and SCC (21%) than in nevomelanocytic proliferations (7%).
- SCC with residual tumor showed a statistically significant increase in adenomatous metaplasia compared to nevomelanocytic neoplasms (35% vs. 7%, P = 0.01).
Conclusions:
- Adenomatous metaplasia is a metaplastic change that can involve eccrine glands.
- This reaction pattern appears more common in epithelial malignancies, potentially induced by tumor-secreted factors.
- Further immunohistochemical and molecular studies are needed to elucidate the exact cause of this metaplasia.
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