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PubMed1989

Malignant dermal cylindromas. Do they exist? A morphological and immunohistochemical study and review of the literature.

Malignant dermal cylindromas are very rare. We present a case of multiple cylindromas of the scalp with metastasis to a cervical lymph node. The morphology of the tumour was unusual in that it contained eccrine spiradenoma-like areas and foci of squamous differentiation with keratin formation. The immunohistochemical phenotype of the eccrine spiradenoma-like areas and the metastatic tumour was similar, but different from the areas of typical cylindroma. Although alleged "malignant" cylindromas have been reported, none have been described to have metastasized, whereas metastatic eccrine spiradenoma is well-documented. We reiterate that overlaps between dermal cylindroma and eccrine spiradenoma are more common than has been documented. In the rare event of metastases, it is the eccrine spiradenomatous component that is metastatic. We contend that there is no evidence that pure dermal cylindromas have metastasized.

Carcinoembryonic Antigen↗

PubMedDate not supplied

[Intracranial cylindroma (cylindromatous epithelioma)].

A case with intracranial cylindroma is reported. Intracranial cylindroma possesses local destructive growth and may recur repeatedly and produce metastases; it is localized on the base of the skull in the chiasmal area or, more frequently, in the region of the trigeminal ganglion. Cylindroma of chiasmal localization develops from ectopic mucous glands of the nose or nasal sinuses, whereas cylindroma of the trigeminal ganglion arises from the glandular epithelium of the auditory tube. Intracranial cylindroma is sensitive to radiation therapy. In the case discussed, the cylindroma was localized in the chiasmal area.

Adenoma, Chromophobe↗

PubMed1999

A comparison of the expression of known basement membrane components with the linear IgA disease antigens using the novel substrate cylindroma.

Linear IgA disease (LAD) is characterized by IgA basement membrane zone autoantibodies. Immunofluorescence, immunoblotting and immunoelectron microscopy studies have established the complexity and heterogeneity of the target antigens. We have studied the expression of the LAD antigens by cylindroma, a benign epithelial tumour that secretes abundant basement membrane, using 57 LAD sera categorized by indirect immunofluorescence on intact and salt-split skin. The expression of known components of hemidesmosomes, the anchoring filaments, extracellular matrix and the anchoring fibrils could be differentiated and were compared with the expression of the LAD antigens. The results showed that the LAD sera bound to the cylindroma tumour in two distinctive patterns. Thirty-three sera were positive on cylindroma. Twenty-seven sera bound to the basement membrane around the tumour clusters and the islets within the clusters in a thin linear band that was occasionally discontinuous. This was similar to the pattern observed with antibodies to the hemidesmosome components, the alpha6beta4 integrin and the bullous pemphigoid antigens BP230 and BP180. This pattern was observed with sera that bound to the epidermal (11) and the dermal (3) aspects of split skin or were negative (11), and with one serum which bound only to intact skin. Seven sera, all binding to the dermal aspect of split skin, bound the tumour cluster basement membrane in a thick band that was identical in appearance to that seen with antibodies to collagen VII; however, binding to the islets was either identical to collagen VII or similar but differentiated with double staining. Some sera were negative on cylindroma. Using fluorescence overlay antigen mapping we demonstrated colocalization of some epidermal-associated LAD target antigens with known hemidesmosome proteins, and colocalization of some dermal-associated LAD target antigens with anchoring fibril components. The results using cylindroma as substrate suggest that LAD autoantibodies may react with three or more target antigens. We propose from the results of this study that the autoantibodies in LAD target multiple antigens associated with hemidesmosomes and anchoring fibrils.

Adult↗

PubMed2001

Malignant transformation of multiple dermal cylindromas.

Cylindromas are benign tumours arising as small, solitary, slow-growing nodules on the head and neck. Multiple cylindromas may form a 'turban tumour' in the autosomal dominant Brooke-Spiegler syndrome. We report two unusual cases of multiple cylindromas with transformation into cylindrocarcinomas. The first patient, a 63-year-old white woman, developed a cylindrocarcinoma on pre-existing multiple cylindromas on her right shoulder. Eight months after resection she developed a lymph node metastasis in the right axilla. The second patient, a 68-year-old white woman, presented with multiple cylindromas of the scalp. One of these transformed into a cylindrocarcinoma, infiltrating the dura mater, with local recurrence 2 years after incomplete resection and postoperative radiation.

Aged↗

PubMed1995

A nevoid plaque with histological changes of trichoepithelioma and cylindroma in Brooke-Spiegler syndrome. An immunohistochemical study with cytokeratins.

Brooke-Spiegler syndrome is characterized by the development of multiple trichoepitheliomas and cylindromas. In addition, multiple spiradenomas have been observed in this autosomal-dominant inherited disease. We report a 53-year-old woman with multiple cylindromas on the head and neck and multiple trichoepitheliomas on the face. Additionally, she had had since birth a plaque on the right side of her neck containing two nodules with features of both cylindroma and trichoepithelioma. Immunohistochemical investigations revealed in the basaloid cells of trichoepithelioma an expression of CK 5/6, CK 14, CK 17, CK 19 and vimentin. The cells of the cylindroma lacked vimentin but expressed additionally CK 7, CK 8 and CK 18. The occurrence of cylindroma and trichoepithelioma in a single nevoid plaque from a patient with Brooke-Spiegler syndrome implies an alteration in the stem cells of the folliculosebaceous-apocrine unit and could be characteristic of the disorder.

Antibodies, Monoclonal↗

PubMed1979

[Tracheal and bronchial cylindromas (author's transl)].

Cylindromas, characterized by its invasive growth, contain 3.7% of all adenomas of bronchial tree (160). Two of 10 cases of tumours mestastized. However, unqualified cylindromas attaching to cancers (adenoid cystic cancer) is not justified. Histological structure of cylindromas is more variable than it is described by other authors. It is proposed to differ 4 histological variants: cribrouse, trabecular, and chondroid. Histological, histochemical and electronmicroscopical analysis allowed to discover the dual character of tumour cell secretion. As to its chemical composition, the secretion of the lumen of mucous tubulae resembles the ordinary mucus, but in cribrouse nests and across trabecular periphery and solid nests it was discovered the particular (special) secretion, rich in acid mucopolysaccharides. Feyrter's observation of endocrine activity of cylindromas are not confirmed. Tissue source of cylindromas of different localizations, in particular, bronchial may be myoepithelial cells.

Adolescent↗

PubMed1977

Multicentric dermal-type cylindromas of the parotid glands in a patient with florid turban tumor.

Dermal-type cylindromas of parotid glands in a patient with turban tumor, and various adnexal tumors, represent a rare diathesis, apparently not reported previously. A Caucasian man, born in 1916, had a scalpectomy for turban tumor in 1957. In 1957, 1960, and 1974, dermal type cylindromas were excised from portions of both parotid glands, developing from intercalated and striated ducts; they were considered benign, based on long term followup. Adrexal tumors included multiple dermal cylindromas, trichoepitheliomas, eccrine spiradenomas, and Bowen's disease, and occurred on almost all skin surfaces. In November, 1976, a portion of a right parotidectomy included a 3.5 X 3-cm malignant tumor having the characteristics of an invasive poorly differentiated spindle cell epidermoid carcinoma, which showed no evidence of originating from a malignant basal cell tumor. Several encapsulated and developing benign basal cell tumors were included in the specimen. Dermal-type cyclindromas of the parotid gland are considered to be a variant of basal cell ademona, or monomorphic adenoma, basal cell type, since they consist of similar cell components, although of somewhat different arrangement and with prominent focal deposition of hyaline. Dermal-type cylindromas should be excised conservatively as they appear. They must be differentiated from adenoid cystic carcinoma, which is an infiltrating neoplasm and requires a radical surgical approach.

Adolescent↗

PubMed1993

Cutaneous cylindroma with malignant transformation.

BACKGROUND: Malignant cutaneous cylindroma is a rare tumor. It has been described in 26 cases, both in the solitary form and in the autosomal dominant inherited multiple tumor form. The authors present two new cases that occurred in one family with a history of multiple cylindromas. METHODS: Clinical and histopathologic data of both tumors were compared with those of 26 other cases in the literature. Immunohistochemical examinations were performed. RESULTS: The malignant tumors were distinguished from the benign lesions by rapid growth, long-standing ulceration, or bleeding. Histopathologic examination showed a well-differentiated carcinoma in one patient and a poorly differentiated tumor in the other. In the latter, lymph node metastasis developed, and the patient died 2.5 years later. Histopathologic criteria of malignancy included cell pleomorphism, frequent mitoses and loss of jigsaw pattern, peripheral palisading, hyaline sheaths, and dual cell population. CONCLUSIONS: These observations are in accord with those in the literature. Malignant cutaneous cylindroma developed more often in the multiple tumor form than in the single tumor form. Malignant cylindroma is an aggressive carcinoma with a tendency to local destructive growth and metastases.

Aged↗

PubMed1980

Benign eccrine cylindroma of the external auditory canal.

The benign eccrine cylindroma is one of a number of histologically different tumors of the external auditory canal that have been grouped by some as "ceruminomas." The eccrine cylindroma, malignant apocrine gland tumors, and the adenoid cystic carcinomas of salivary gland origin are distinctly different histologically and in natural history and prognosis. Therapy should, therefore, be tailored to the specific tumor. A patient is presented who developed an asymptomatic external auditory canal mass that was initially incompletely excised. A recurrence five years later again proved to be a benign eccrine cylindroma of sweat gland origin. Successful and adequate treatment was local excision with a cuff of normal tissue. A variety of tumors originating from the adnexal skin structures may appear in the external auditory meatus and canal. Treatment must include biopsy and close consultation with the pathologist. The term cylindroma has been loosely applied to both benign and malignant glandular neoplasms but its usage should be restricted to the specific benign eccrine cylindrome herein described. A rationale of therapy is presented.

Carcinoma, Adenoid Cystic↗

PubMed1987

Adenoid-cystic carcinoma (cylindroma) of the pyriform sinus in pediatric age.

Adenoid cystic tumors or cylindromas are malignant tumors typical of salivary tissue which often develop in minor salivary glands and, according to some authors, also in common mucosa glands. In these cases such tumors are particularly malignant owing to the frequency in which they re-occur locally and develop distant metastases. The authors report a case of a cylindroma of the pyriform sinus in a young child. An accurate review of the literature did not reveal any previous reports of analogous cases of cylindroma in the pyriform sinus of such a young subject. This finding created notably difficult problems with regard to therapy planning. After discussion of problems, conservative surgery is indicated as the most suitable treatment in these cases, considering that chemotherapy and radiation therapy alone are not highly effective in treating cylindromas and, furthermore, they are contraindicated because of the young age of the patient.

Carcinoma, Adenoid Cystic↗

PubMed2002

Defective laminin 5 processing in cylindroma cells.

Cylindromas are benign skin tumors occurring as multiple nodules characteristically well circumscribed by an excess of basement membrane-like material. To determine the molecular defects leading to extracellular matrix accumulation, the ultrastructural, immunological, and biochemical properties of cylindroma tissue and isolated cells were analyzed. In cylindromas, hemidesmosomes are reduced in number, heterogeneous and immature compared to the normal dermal-epidermal junction. Expression of the alpha6beta4 integrin in tumor cells is weaker than in basal keratinocytes of the epidermis. Moreover, although in the epidermis alpha2beta1-integrin expression is restricted to the basal cell layer, it is found in all neoplastic cells within the nodules. Laminin 5 is present throughout the whole thickness of the basement membrane-like zone whereas laminin 10 is restricted to the interface adjacent to the tumor cells. Furthermore, laminin 5 is not properly processed and most of the alpha3A and gamma2 laminin chains remain as 165-kd and 155-kd polypeptides, respectively. Mature laminin 5 is thought to be necessary for correct hemidesmosome and basement membrane formation and its abnormal processing, as well as the low expression of alpha6beta4 integrins, could explain the lack of mature hemidesmosomes. Together, the results show that multiple molecular defects, including alteration of laminin 5 and its integrin receptors, contribute to structural aberrations of the basement membrane and associated structures in cylindromas.

Antibodies↗

PubMed1999

Spiradenocylindromas of the skin: tumors with morphological features of spiradenoma and cylindroma in the same lesion: report of 12 cases.

Twelve cases of spiradenocylindromas, which revealed features of both spiradenoma and cylindroma in the same tumor mass, are presented. Nine female patients had multiple neoplasms occurring mostly on the scalp, and two female and one male patient had a solitary cutaneous lesion. Three of the female patients with multiple cutaneous tumors had a familial history of similar cutaneous neoplasms. In one of the patient's family, the multiple cutaneous tumors were known to occur in multiple family members in four consecutive generations. One patient with multiple cutaneous lesions was known to have associated multiple kidney cysts as confirmed by computed tomography. Histologically, spiradenocylindromas are composed of intermixed areas that are either of typical spiradenoma in appearance or of typical cylindroma appearance. Apocrine and trichoepitheliomatous differentiation seen in two cases in the present series points to spiradenomas, as well as cylindromas, having complex hair follicle (folliculo-sebaceous apocrine) rather than eccrine differentiation. The presence of lymphoid tissue was a histological feature in the present series, which was prominent in all the spiradenomatous parts of the tumors and which was scanty or practically absent in all the cylindromatous parts. The selective presence of lymphocytes in spiradenoma and an absence in cylindroma suggest that spiradenomas have the unique property of attracting lymphocytes. The malignant tumors arising in three patients in the present series had the morphology of a poorly differentiated epithelioid neoplasm. Three patients died of the disease and the other patients were either free of disease or alive with disease 1-30 years on follow up.

Adenoma↗

PubMed1999

[Bilateral basal cell adenoma of the parotid gland and miltiple cylindromas of the skin--is there a syndromal coincidence?].

BACKGROUND: Compared to the typical carcinomas of the upper aerodigestive tract the benign tumours of the salivary glands show significant histological diversity. Therefore correct histological diagnosis might be difficult even for the pathologist. Basal cell adenoma may have a multifocal origin and can be associated with cylindromas of the skin. PATIENTS: In 17 patients with an average age of 65.8 a basal cell adenoma of a major salivary gland was diagnosed with a slight preponderance of the female sex (10:7). RESULTS: One male patient showed a bilateral basal cell adenoma of the parotid gland and simultaneously multiple cylindromas of the skin in the head and neck region. There might be a syndromal coincidence, since histology revealed similar features of the salivary gland tumours compared to the skin neoplasias. The patient's history gave hints of a familial occurrence of the dermal cylindromas. CONCLUSIONS: In rare cases a basal cell adenoma of the dermal type may be associated with cylindromas of the skin suggesting a common histogenesis. Due to possible multifocal origin and the menacing risk of malignant transformation a thorough follow-up of the patients after surgical treatment is mandatory.

Adenoma↗

PubMed1995

The pathogenesis of familial multiple cylindromas, trichoepitheliomas, milia, and spiradenomas.

Early stages in the development of hereditary cylindromas associated with trichoepitheliomas, milia, and spiradenomas revealed that (a) trichoepitheliomas were derived from the bulges of hair follicles and probably represented an abnormal histogenesis from which rarely poorly differentiated trichoepitheliomas developed; (b) milia were the result of cystic alteration of the trichoepitheliomatous bulge proliferations; and (c) cylindromas and spiradenomas were different appearances of the same tumor and developed from two separate sources, follicular bulge proliferations and eccrine glands. From the bulge proliferations multiple cylindromatous buds developed that, by increasing in number, formed the classical cylindroma and, by increasing in size rather than in number, gave the spiradenomatous variant. Eccrine glands transformed into cylindromas by cylindromatous growth from the basal cell layer. Connections between the original structures and the tumors were mostly lost. Tumors from both sources revealed the same morphology, which was most indicative of eccrine differentiation including secretory and excretory elements. Apocrine differentiation was a rare and possibly secondary event. The multiplicity in derivation and differentiation suggest an adnexal progenitor cell as the most likely source.

Adenoma↗

PubMed1991

Malignant cylindroma of the scalp.

Malignant cylindroma may develop via malignant transformation of cylindroma in rare instances or may develop de novo in others. We present a case of malignant cylindroma located on the left parietal-occipital scalp that was treated twice by Mohs micrographic surgery in an attempt to excise the tumor completely and to minimize the excision of normal tissue. Our case is the sixteenth reported case of malignant cylindroma in the world literature.

Aged↗

PubMed1989

Type VII collagen is a component of cylindroma basement membrane zone.

Cylindroma basement membranes (BMs) were studied by electron microscopy and immunofluorescence with antibodies to Types IV and VII collagen in order to correlate the ultrastructure with the biochemical characteristics. Type IV collagen served as a marker for lamina densa structures and Type VII collagen for the anchoring fibrils. Ultrastructurally, the cylindroma BMs were composed of a wide band of BM-like material in which numerous anchoring fibrils were embedded. The BMs surrounding the tumor cell clusters and nodules of BM-like material entrapped within the tumor cell islands stained positively for both Types IV and VII collagen. We conclude, that anchoring fibrils are a major component of cylindroma BM zone. A trichoepithelioma investigated as control showed a BM similar to the one found at the dermoepidermal junction, i.e. a BM distinctly different from the one of cylindroma. The trichoepithelioma BMs and nodules of BM-like material included within the tumor also stained positively for both Type IV and VII collagen.

Adult↗

PubMed1993

Cylindroma expresses immunohistochemical markers linking it to eccrine coil.

Nerve growth factor, S-100 protein, CD44, and CD34 have unique expressions in or surrounding eccrine coil but are not found in eccrine duct or apocrine gland. We studied 15 cases of cutaneous cylindroma to see if these antigens are found in this neoplasm. All were found in cylindroma to varying degrees. These results link the histogenesis of cylindroma to the eccrine coil. A unique feature of cylindroma is the large number of prominent dendritic cells most likely representing Langerhans cells that permeate the tumor aggregates.

Antigens, CD↗

PubMed1994

Linear IgA disease: cylindroma demonstrates heterogeneity of the target antigens.

Serum from 58 patients with linear IgA disease was tested by indirect immunofluorescence on the novel substrate cylindroma, which produces an abundance of basement membrane components. The use of split skin and of cylindroma has identified 2 target antigens. The majority of patients have a target antigen associated with epidermal cells and similar in distribution on cylindroma to hemidesmosome proteins. A minority have a dermal antigen with the distribution of collagen VII on cylindroma. These data support the hypothesis that linear IgA disease is a heterogeneous disease with regard to the target antigens.

Adenoma↗