Spiradenoma and cylindroma originate from the hair follicle bulge and not from the eccrine sweat gland: an immunohistochemical study with CD200 and other stem cell markers.
BACKGROUND
Spiradenoma and cylindroma have historically been described as sweat gland tumors and have often been considered to be of eccrine lineage. However, (a) associations with trichoepitheliomas in Brooke-Spiegler syndrome or with trichoepitheliomas and milia in Rasmussen syndrome, (b) neoplastic combinations with hair follicle tumors in solitary cases, and (c) anatomical considerations support a folliculosebaceous-apocrine lineage. Follicular stem cell markers may allow for further characterization of these neoplasms.


METHODS
A total of 97 tumors were examined for the expression pattern of follicular stem cell markers cytokeratin 15 (CK15), cytokeratin 19 (CK19), pleckstrin homology-like domain, family A, member 1 (PHLDA1), and CD200. The tumors were comprised of 27 spiradenomas, 30 cylindromas, 16 hidradenomas, 19 poromas, 4 dermal duct tumors and 1 hidroacanthoma simplex.


RESULTS
All spiradenomas and cylindromas were CD200-positive whereas the other tumors classified as eccrine in lineage were all CD200-negative. CK15 also discriminated between spiradenomas and cylindromas and the remaining neoplasms but not to the degree of CD200. PHLDA1 and CK19 were noncontributory.


CONCLUSIONS
It is concluded that both spiradenoma and cylindroma are not eccrine but follicular tumors. More specifically, it is proposed that both adnexal neoplasms are derived from the hair follicle bulge and as such represent one of the least differentiated follicular tumors.
['Sellheyer|Klaus|K|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D015703:Antigens, CD D014408:Biomarkers, Tumor D003528:Carcinoma, Adenoid Cystic D004439:Eccrine Glands D005260:Female D018859:Hair Follicle D006801:Humans D007150:Immunohistochemistry D053569:Keratin-15 D008297:Male D008875:Middle Aged D014411:Neoplastic Stem Cells D012867:Skin D013544:Sweat Gland Neoplasms D013545:Sweat Glands D055815:Young Adult
spiradenoma cylindroma CD200 stem cells sweat gland tumors