Chondroid syringoma with hyaline cell change

Area of Science:

• Dermatopathology
• Surgical Pathology
• Oncology

Background:

• Chondroid syringoma is a rare skin tumor.
• Hyaline cells are uncommon in chondroid syringoma, often causing diagnostic challenges.
• These cells can be mistaken for malignant cells, such as in sarcomas.

Purpose of the Study:

• To describe four cases of chondroid syringoma with a prominent hyaline or plasmacytoid cell component.
• To investigate the diagnostic features and immunohistochemical profile of these tumors.
• To elucidate the cellular origin of the hyaline cells in chondroid syringoma.

Main Methods:

• Histopathological examination of four tumor samples.
• Immunohistochemical staining for various markers (vimentin, cytokeratin, S-100, CEA, GFAP, NSE, α-SMA, Ber EP4).
• Ultrastructural analysis of hyaline cells.

Main Results:

• Four cases of chondroid syringoma with numerous hyaline/plasmacytoid cells were identified (3 hand, 1 foot).
• Diagnostic features included tubulo-glandulo-ductal structures, benign squamous epithelium, and myxochondroid stroma.
• Immunohistochemistry showed hyaline cells positive for vimentin, cytokeratin, S-100, CEA, and focally for GFAP, NSE, and α-SMA. Some cells showed peripheral ring-like positivity for cytokeratin and S-100.
• Ultrastructure revealed desmosomes, tonofibrils, and intermediate filaments.

Conclusions:

• Hyaline cells in chondroid syringoma likely represent modified epithelial and myoepithelial cells.
• The presence of hyaline cells can lead to diagnostic difficulties, including suspicion of sarcoma.
• Characteristic histological and immunohistochemical findings aid in accurate diagnosis.