Michelle Dubb1, Pam Michelow. 1. Cytology Unit, Department of Anatomical Pathology, National Health Laboratory Service and University of the Witwatersrand, Johannesburg, South Africa. mdubb@telkomsa.net
Abstract
BACKGROUND: Fine needle aspiration (FNA) cytology is a well-established diagnostic tool. However, most clinicians prefer to diagnose suspected skin tumors by excisional biopsy as they are easily accessible, with the result that benign skin adnexal tumors are rarely encountered on FNA, often leading to misdiagnosis and mismanagement of patients. We describe the cytologic features of chondroid syringoma in 3 cases in order to facilitate cytologic diagnosis of this lesion. CASES: Three patients each presented with a mass lesion in the head and neck region and on FNA were diagnosed as having chondroid syringomas. All diagnoses were confirmed on histology. Case 1 was a 32-year-old female who presented with a 2-cm mass involving the scalp. Case 2 was an 18-year-old female who presented with a 0.5-cm mass involving the skin of the upper lip. Case 3 was a 23-year-old male with a 2-cm mass involving the posterior scalp. All the masses involved the skin/subcutaneous tissue on clinical examination. On cytology, all 3 cases showed background fibrillary chondromyxoid material, with a prominent cellular component composed of bland epithelial and myoepitheial cells. The presence of random nuclear atypia was seen in 1 case, interpreted as degenerative as seen in ancient change. CONCLUSION: Knowledge of the cytologic features of chondroid syringoma will allow definitive diagnosis and correct management of the patient.
BACKGROUND: Fine needle aspiration (FNA) cytology is a well-established diagnostic tool. However, most clinicians prefer to diagnose suspected skin tumors by excisional biopsy as they are easily accessible, with the result that benign skin adnexal tumors are rarely encountered on FNA, often leading to misdiagnosis and mismanagement of patients. We describe the cytologic features of chondroid syringoma in 3 cases in order to facilitate cytologic diagnosis of this lesion. CASES: Three patients each presented with a mass lesion in the head and neck region and on FNA were diagnosed as having chondroid syringomas. All diagnoses were confirmed on histology. Case 1 was a 32-year-old female who presented with a 2-cm mass involving the scalp. Case 2 was an 18-year-old female who presented with a 0.5-cm mass involving the skin of the upper lip. Case 3 was a 23-year-old male with a 2-cm mass involving the posterior scalp. All the masses involved the skin/subcutaneous tissue on clinical examination. On cytology, all 3 cases showed background fibrillary chondromyxoid material, with a prominent cellular component composed of bland epithelial and myoepitheial cells. The presence of random nuclear atypia was seen in 1 case, interpreted as degenerative as seen in ancient change. CONCLUSION: Knowledge of the cytologic features of chondroid syringoma will allow definitive diagnosis and correct management of the patient.