Page 9 - DermPath Correlation

from Murphy is both practical and a more realistic way of looking at adnexal tumours because
many have elements of more than one adnexal structure!

Assess first whether a benign or malignant lesion.

Benign are structured, symmetrical, ordered and don't have lots of mitoses.

Malignant are asymmetrical, disordered , having varying sized nuclei with some prominent
nucleoli and show many mitoses.

Thereafter look at the tumour from one of the following descriptive groups.

1. Partially and fully cystic lesions.
2. Tumours with nests, cords and ducts.
3. Tumours forming sheets and nodules.

Group 1 - Cysts or partial cysts - Epidermal inclusion cysts, Pilar sheath acanthoma, dilated pore
of Winer, Trichilemmal (pilar) cyst, Steatocystoma, Hair matrix cyst, Apocrine cystadenoma,
Syringocystadenoma papilliferum, Hidradenoma papilliferum.

Mnemonic PTS(D)H
P - Pilar sheath acanthoma, Pore of Winer, Trichilemmal (Pilar) cyst, Steatocystoma,
Syringocystadenoma papilliferum, Hidradenoma papilliferum, Hair matrix cyst

Group 2- Nests, Cords and Ducts- Trichoepithelioma, Desmoplastic trichoepithelioma,
Trichofolliculoma, Cylindroma, Syringoma, Papillary adenoma, Mixed tumour., Chondroid
syringoma, Microcystic adnexal carcinoma

Mnemonic TCA- Trichoepthelioma, Cylindroma, Syringoma and desmoplastic variants, Chondroid
syringoma, Papillary adenoma, Microcystic adnexal carcinoma, Carcinoma breast mets

Group 3 Sheets and nodules - Poroma, Trichilemmoma, Nodular hidradenoma, Pilomatricoma,
Spiradenoma, Sebaceous hyperplasia, Sebaceous adenoma, Sebaceous nevus,

Mnemonic - PTS(D)H again - Poroma, Trichilemmoma, Sebaceous tumours, Sebaceous nevus,
Spiradenoma, Hidradenoma