An apocrine hidradenoma is a benign adnexal neoplasm, usually covered by intact skin, but may show superficial ulceration and serous discharge. This feature is raising the possibility of malignancy as it was in our case of macroscopically suspicious tumour. We described cytomorphologic features of cutaneous nodule that might be a lead to the cytologic diagnosis of hidradenoma, but primary or secondary malignant tumour has been ruled out first

Gordana Kaić

Karmen Trutin Ostović

Marija Škoro

Nina Petra Novak

Rado Žic

Čedna Tomasović-Lončarić

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Coll. Antropol. 34 (2010) 2: 671–674Case reportFine-Needle Aspiration Cytology of ApocrineHidradenomaNina Petra Novak1, Gordana Kai}1, ^edna Tomasovi}-Lon~ari}1, Rado @ic1,2, Marija [koro1and Karmen Trutin Ostovi}1,31 Dubrava University Hospital, Zagreb, Croatia2 Zagreb University, School of Medicine, Zagreb, Croatia3 University of Applied Health Studies, Zagreb, CroatiaA B S T R A C TAn apocrine hidradenoma is a benign adnexal neoplasm, usually covered by intact skin, but may show superficial ul-ceration and serous discharge. This feature is raising the possibility of malignancy as it was in our case of macroscopi-cally suspicious tumour. We described cytomorphologic features of cutaneous nodule that might be a lead to the cytologicdiagnosis of hidradenoma, but primary or secondary malignant tumour has been ruled out first.Key words: skin tumours, hidradenoma, fine-needle aspiration, cytology, diagnosisIntroductionA cytologic study of skin nodules and distinction ofmetastatic lesions from primary cutaneous and subcuta-neous neoplasms may be difficult. A hidradenoma is a be-nign adnexal neoplasm, closely related to poroma, thatdisplays a limited degree of ductal differentiation. Whilehistorically considered eccrine, recent evidence suggeststhat the hidradenoma can be either apocrine or eccrinedifferentiation. The synonyms for this entity are: clearcell hidradenoma, nodular hidradenoma, poroid hidrade-noma, acrospiroma and solid-cystic hidradenoma1,2. Thehidradenomas have sporadic presentation and no sexpredilection. Most of them develop in adults and thoseare usually solitary, asymptomatic, intradermal nodules,measure between 0.5 and 12 cm in diameter. They com-monly develop on the scalp, the trunk and proximal ex-tremities, presenting as skin-coloured to red-brown orblue nodules1,3. It’s usually covered by intact skin, butmay show superficial ulceration and serous discharge.This feature raises the possibility of malignancy3,4. Thepurpose of this article is to describe the clinical andcytomorphologic features of our case of an apocrine hi-dradenoma. We want to point out that these findingsmay be a potential pitfall even for experienced cytopatho-logists.Case ReportA 70-year-old, healthy man presented with a 2-yearhistory of a subcutaneous nodular lesion on the right sideof the chest under the breast. Since last six months thelesion has been growing faster. A physical examinationrevealed an red-coloured, egzulcerated tumour measured2.5 cm in diameter. A serous-bloody discharge was notedon the tumor surface. A fine-needle aspiration cytology(FNAC) was performed, repeated several times at the dif-ferent portions of the tumour. The yielded material wasplaced and smeared on the slides, air-dried and May--Grünwald Giemsa (MGG) stained. The cytology smearsshowed numerous large three-dimensional groups of mo-nomorphic cells with small rounded nuclei and occasion-ally conspicous nucleoli. The cells had a scant basophiliccytoplasm and occasionally a moderate amount of clearcytoplasm. Some smaller and less cohesive cell clusters671Received for publication July 18, 2009displayed rounded rosette-like structures. In the back-ground there were a few scattered naked nuclei, particlesof amorphous extracellular basophilic material and blood.The immunocytochemical reactions were unsuccesefuldue to technical reasons. The cytologic diagnosis was:neoplasm of probably epithelial origin, metastatic tu-mour couldn’t be excluded. A surgical excision was rec-ommended.Macroscopic patohistologic examination revealed ex-tirpated skin measuring 8x3.5x3.5 cm with tumorousprotuberance of 2.5 cm in diametar. Microscopically tu-mour has been well circumscribed from surrounding tis-sue and hasn’t reached to the resection edges. It con-sisted predominantly solid areas of two cell types: eosi-nophilic and clear cells. The eosinophilic cells were occa-sionally forming tubular and cystic structures. An inter-vening, partly hyalinized stroma divided cell clustersinto lobules of various sizes (Figure 1). The histologic di-agnosis was apocrine hidradenoma. Three years aftersurgery, the patient was free of the disease.The cytology smears were reviewed and described be-low. The cellular smears shows clusters of two cell types(Figure 2). The first type were cuboidal epithelial cellswhich formed large, cohesive, three-dimensional papil-lary-like, dense packing clusters. These cells had roun-ded to ovoid nuclei, small nucleoli and a scant to moder-ate, slight granular, basophilic cytoplasm. Occasionallythey were reminiscent to squamoid cells and their nucleishow overlapping, mild hyperchromasia and anisonu-cleosis (Figure 3). The rounded rosette-like formationswere rare but discernible (Figure 4). The second type ofcells had round, eccentric nuclei, fine granular chro-matin and small nucleoli. The cytoplasms of these cellswere more abundant, slight eosinophilic or gray to wa-tery-clear coloured (Figure 5). They formed middle sized,flatter clusters. In the background there was an amor-phous basophilic extracellular material, some histiocy-tes, fibrocytes, pigmentophages, naked nuclei and blood.The periodic acid-Schiff-diastase (PAS-D) reaction is de-monstrated in both cell types, but the strongest in thecells with an abundant clear cytoplasm (Figure 6).DiscussionNeoplasms of cutaneous appendages are relativelyuncommon lesions, and because they are encountered soinfrequently in clinical cytology practice sometimes posedifficulty in diagnosis. The hidradenoma is usually cov-ered by intact skin, but may show superficial ulcerationN. P. Novak et al.: FNAC of Apocrine Hidradenoma, Coll. Antropol. 34 (2010) 2: 671–674672Fig. 1. Histologic section: Tumour tissue consists of solid areasand two cell types: eosinophilic cells and clear cells (Hematoxylin& Eosin, x100).Fig. 2. Cytologic smear: The cohesive clusters of cuboidal, occa-sionally squamoid cells and the second type of cells with moreabundant, occasionally clear cytoplasms. In the background thereis basophilic extracellular material (top right) (MGG, x100).Fig. 3. The cuboidal cells show mild hyperchromasia, anisonu-cleosis, overlapping nuclei and conspicious small nucleoli (MGG,x1000).Fig. 4. The cell cluster with rosette-like formations (MGG, x1000).and serous discharge as it was in our case of macroscopi-cally suspicious tumour. Microscopically, it is composedof several types of cells. When predominate clear or palecells with distinct cell borders, the name clear cell hidra-denoma is appropriate1. Hybrid lesions include compactporoid cells with prominent ductal differentiation havebeen referred to as poroid hidradenomas1. The clear cellscontain glycogen and periodic acid-Schiff-positive, dia-stase-resistant material, but no lipid5. The squamoidcells are polygonal with a central vesicular nuclei and aneosinophilic cytoplasm, often arranged in whorls1. Theymay even be cornified with formation of horn pearls6.Mucinous cells are the least common component. Theseare large cells with fine basophilic granular cytoplasm,cuboidal or columnar in shape. The cells line the tubulesand may show evidence of apocrine differentiation. Tran-sition between different types of cells is frequent. Whenwe reviewed cytology smears we noted two types of thecells, corresponding to the description above. Cellularsmears revealed large cohesive three-dimensional papil-lary-like clusters of dense packing cuboidal epithelialcells and middle sized, flatter clusters of cells with abun-dant, partially clear cytoplasm. As the quantity of differ-ent cells type vary markedly in different tumours, onemust be aware of the resemblance to metastatic renal cellcarcinoma, squamous cell carcinoma or signet-ring ade-nocarcinoma4,5. In the case of apocrine hidradenomawith pseudopapillary cell clusters, metastases of papil-lary carcinoma must be excluded7. The nuclear groovingrecently described as a common finding in these tu-mours, also confirmed by electron microscopy6 hasn’tbeen noticed in our case.The nuclei of neoplastic cells may be hyperchromatricand exhibit coarsely clumped chromatin, but presence ofmarked pleomorphism and frequent or atypical mitosesis not observed3. In our case we have seen mild hyper-chromasia, anizonucleosis and overlapping nuclei withsmall distinct nucleoli. Some authors describe mild pleo-morphism, multinucleation and occasional mitotic fig-ures in rare case of recurrent poroid hidradenoma8. Closefollow-up is necessary because histology is not always areliable indicator of biologic behaviour9.The hidradenoma often has cystic spaces that maycontain eosinophilic, homogenous material as a result ofdegeneration of the tumour cells6. That material shouldnot be mistaken for tumorous diathesis which with an-other features of malignancy like aggresive local growth,pleomorphism, numerous mitotic figures, angiolympha-tic and perineural invasion lead to diagnosis of hidrade-nocarcinoma5,6,9,10. Most of malignant forms of nodularhidradenoma are malignant from their inception, butsome develop from benign hidradenoma6. The hidrade-nocarcinomas are rare and tend to be moderate size, buta growth rate of both malignant and benign tumours isslow. Cytologic features indicative for malignancy may notbe obvious. Futher, in differential diagnosis we shouldconsider other primary appendageal benign and malig-nant tumours same as other malignant skin tumours likea basal cell carcinoma, Merkel cell carcinoma or malig-nant melanoma2,8,11.The PAS stain with diastase digestion were done addi-tionally on a residual smears. We demonstrated a posi-tivity in the cytoplasm of the clear cells as other authorsclaimed8,11. Hidradenomas could react with different mo-noclonal antibodies such as: citokeratin, specially CKLMW, EMA, CEA, S-100 protein, vimentin3,5.Complete excision is usually curative, but hidrade-noma may occasionally recure after local excision1,3. Thefirst case of nodular hidradenoma diagnosed by fine-nee-dle aspiration cytology was reported in 199612. Knowl-edge of the cytologic features of primary skin adnexalneoplasms helps distinguish them from the cutaneousmetastases which were more commonly referred forFNAC evaluation. Detailed clinical history, physical find-ings, and ancillary studies are essential add for correctdiagnosis. Even more skill is required to recognize spe-cific entities in a broad group of appendageal tumours.Considering that hidradenoma is an uncommon tumourand an experience in FNAC of such lesions is insufficient,we hope we made a useful contribution with this report.ConclusionDespite the fact that we missed the correct diagnosis,FNAC determined the need for surgical excision andN. P. Novak et al.: FNAC of Apocrine Hidradenoma, Coll. Antropol. 34 (2010) 2: 671–674673Fig. 5. The apocrine cells with eosinophilic cytoplasm andclear cells (MGG, x1000).Fig. 6. The cytochemical PAS-D reaction demonstrated thestrongest positivity in the clear cells (x1000).histologic evaluation. We belive that cytologic findings ofthree-dimensional papillary-like clusters with mild aty-pia, two types of cells and specific background in smearsof cutaneous nodule might be a lead to the diagnosis ofhidradenoma, but primary or secondary malignant tu-mour has been ruled out first.R E F E R E N C E S1. LEBOIT PE, Appendageal skin tumours. In: LEBOIT PE, BURGG, WEEDON D, SARASIN A (Eds) WHO Classification of Tumours, Pa-thology and Genetics: Skin Tumours, (IARC, Lyon, 2006). — 2. LAYFI-ELD LJ, MOONEY E, Acta Cytol, 42 (1998) 1064. — 3. RAGSDALE BD,MURPHY GF, Tumors of the skin. In: SILVERBERG SG, DELELLIS RA,FRABLE WJ (Eds). Principles and practice of surgical pathology and cy-topathology (Churchill Livingstone, New York, 1997). — 4. MANNION E,MCLAREN K, AL-NAFUSSI AI, Cytopathology, 6 (1995) 100. — 5. VOL-MAR KE, CUMMINGS TJ, WANG WH, CREAGER AJ, TYLER DS, XIEHB, Arch Pathol Lab Med, 129 (2005) 113. — 6. KHURSHID A, YAQOOBN, DEVAN HA, PERVEZ S, J Cutan Pathol, 34 (2007) 871. — 7. PÉREZ--GUILLERMO M, SOLANO JG, Diagn Cytopathol, 30 (2004) 275. — 8.HOSHIDA Y, HANAI J, MATSUSHITA N, YONEKAWA M, KOBAYASHIY, KAWAKAMI H, UCHINO N, AOZASA K, Acta Cytol, 42 (1999) 471. —9. HOLDEN B, COLOME-GRIMMER M, SAVAGE C, STIERMAN K,POU AM, Ear Nose Throat J, 81 (2002) 352. — 10. POHAR-MARIN[EK@, LAMOVEC J, Acta Dermatoven APA, 12 (2003) 94. — 11. CHO S, KIMJS, SHIN JH, KIM JH, KIM HJ, WHANG KK, HAHM JH, Int J Der-matol, 40 (2001) 62. — 12. GOTTSCHALK-SABAG S, GLICK T, DiagnCytopathol, 15 (1996) 395.N. P. NovakDepartment of Clinical Cytology and Cytometry, Dubrava University Hospital, Av. G. [u{ka 6, 10040 Zagreb, Croatiae-mail: dr.nina.novak@gmail.comCITOLO[KA PUNKCIJA APOKRINOG HIDRADENOMAS A @ E T A KApokrini hidradenom je benigna novotvorina ko`nih adneksa, naj~e{}e prekrivena nepromijenjenom ko`om. Pone-kad na ko`i mo`e biti izra`en povr{inski vrijed sa seroznim iscjetkom, obilje`je koje budi sumnju u zlo}udnost pro-mjene, {to je bio slu~aj i u na{eg bolesnika. Opisali smo citomorfolo{ke zna~ajke punktiranog ko`nog ~vora koje mogupomo}i u citolo{koj dijagnozi hidradenoma, uz preduvjet da su isklju~ene mogu}e primarne i sekundarne zlo}udnenovotvorine.N. P. Novak et al.: FNAC of Apocrine Hidradenoma, Coll. Antropol. 34 (2010) 2: 671–674674

English

Fine-Needle Aspiration Cytology of Apocrine Hidradenoma

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Coll. Antropol. 34 (2010) 2: 671–674Case reportFine-Needle Aspiration Cytology of ApocrineHidradenomaNina Petra Novak1, Gordana Kai}1, ^edna Tomasovi}-Lon~ari}1, Rado @ic1,2, Marija [koro1and Karmen Trutin Ostovi}1,31 Dubrava University Hospital, Zagreb, Croatia2 Zagreb University, School of Medicine, Zagreb, Croatia3 University of Applied Health Studies, Zagreb, CroatiaA B S T R A C TAn apocrine hidradenoma is a benign adnexal neoplasm, usually covered by intact skin, but may show superficial ul-ceration and serous discharge. This feature is raising the possibility of malignancy as it was in our case of macroscopi-cally suspicious tumour. We described cytomorphologic features of cutaneous nodule that might be a lead to the cytologicdiagnosis of hidradenoma, but primary or secondary malignant tumour has been ruled out first.Key words: skin tumours, hidradenoma, fine-needle aspiration, cytology, diagnosisIntroductionA cytologic study of skin nodules and distinction ofmetastatic lesions from primary cutaneous and subcuta-neous neoplasms may be difficult. A hidradenoma is a be-nign adnexal neoplasm, closely related to poroma, thatdisplays a limited degree of ductal differentiation. Whilehistorically considered eccrine, recent evidence suggeststhat the hidradenoma can be either apocrine or eccrinedifferentiation. The synonyms for this entity are: clearcell hidradenoma, nodular hidradenoma, poroid hidrade-noma, acrospiroma and solid-cystic hidradenoma1,2. Thehidradenomas have sporadic presentation and no sexpredilection. Most of them develop in adults and thoseare usually solitary, asymptomatic, intradermal nodules,measure between 0.5 and 12 cm in diameter. They com-monly develop on the scalp, the trunk and proximal ex-tremities, presenting as skin-coloured to red-brown orblue nodules1,3. It’s usually covered by intact skin, butmay show superficial ulceration and serous discharge.This feature raises the possibility of malignancy3,4. Thepurpose of this article is to describe the clinical andcytomorphologic features of our case of an apocrine hi-dradenoma. We want to point out that these findingsmay be a potential pitfall even for experienced cytopatho-logists.Case ReportA 70-year-old, healthy man presented with a 2-yearhistory of a subcutaneous nodular lesion on the right sideof the chest under the breast. Since last six months thelesion has been growing faster. A physical examinationrevealed an red-coloured, egzulcerated tumour measured2.5 cm in diameter. A serous-bloody discharge was notedon the tumor surface. A fine-needle aspiration cytology(FNAC) was performed, repeated several times at the dif-ferent portions of the tumour. The yielded material wasplaced and smeared on the slides, air-dried and May--Grünwald Giemsa (MGG) stained. The cytology smearsshowed numerous large three-dimensional groups of mo-nomorphic cells with small rounded nuclei and occasion-ally conspicous nucleoli. The cells had a scant basophiliccytoplasm and occasionally a moderate amount of clearcytoplasm. Some smaller and less cohesive cell clusters671Received for publication July 18, 2009displayed rounded rosette-like structures. In the back-ground there were a few scattered naked nuclei, particlesof amorphous extracellular basophilic material and blood.The immunocytochemical reactions were unsuccesefuldue to technical reasons. The cytologic diagnosis was:neoplasm of probably epithelial origin, metastatic tu-mour couldn’t be excluded. A surgical excision was rec-ommended.Macroscopic patohistologic examination revealed ex-tirpated skin measuring 8x3.5x3.5 cm with tumorousprotuberance of 2.5 cm in diametar. Microscopically tu-mour has been well circumscribed from surrounding tis-sue and hasn’t reached to the resection edges. It con-sisted predominantly solid areas of two cell types: eosi-nophilic and clear cells. The eosinophilic cells were occa-sionally forming tubular and cystic structures. An inter-vening, partly hyalinized stroma divided cell clustersinto lobules of various sizes (Figure 1). The histologic di-agnosis was apocrine hidradenoma. Three years aftersurgery, the patient was free of the disease.The cytology smears were reviewed and described be-low. The cellular smears shows clusters of two cell types(Figure 2). The first type were cuboidal epithelial cellswhich formed large, cohesive, three-dimensional papil-lary-like, dense packing clusters. These cells had roun-ded to ovoid nuclei, small nucleoli and a scant to moder-ate, slight granular, basophilic cytoplasm. Occasionallythey were reminiscent to squamoid cells and their nucleishow overlapping, mild hyperchromasia and anisonu-cleosis (Figure 3). The rounded rosette-like formationswere rare but discernible (Figure 4). The second type ofcells had round, eccentric nuclei, fine granular chro-matin and small nucleoli. The cytoplasms of these cellswere more abundant, slight eosinophilic or gray to wa-tery-clear coloured (Figure 5). They formed middle sized,flatter clusters. In the background there was an amor-phous basophilic extracellular material, some histiocy-tes, fibrocytes, pigmentophages, naked nuclei and blood.The periodic acid-Schiff-diastase (PAS-D) reaction is de-monstrated in both cell types, but the strongest in thecells with an abundant clear cytoplasm (Figure 6).DiscussionNeoplasms of cutaneous appendages are relativelyuncommon lesions, and because they are encountered soinfrequently in clinical cytology practice sometimes posedifficulty in diagnosis. The hidradenoma is usually cov-ered by intact skin, but may show superficial ulcerationN. P. Novak et al.: FNAC of Apocrine Hidradenoma, Coll. Antropol. 34 (2010) 2: 671–674672Fig. 1. Histologic section: Tumour tissue consists of solid areasand two cell types: eosinophilic cells and clear cells (Hematoxylin& Eosin, x100).Fig. 2. Cytologic smear: The cohesive clusters of cuboidal, occa-sionally squamoid cells and the second type of cells with moreabundant, occasionally clear cytoplasms. In the background thereis basophilic extracellular material (top right) (MGG, x100).Fig. 3. The cuboidal cells show mild hyperchromasia, anisonu-cleosis, overlapping nuclei and conspicious small nucleoli (MGG,x1000).Fig. 4. The cell cluster with rosette-like formations (MGG, x1000).and serous discharge as it was in our case of macroscopi-cally suspicious tumour. Microscopically, it is composedof several types of cells. When predominate clear or palecells with distinct cell borders, the name clear cell hidra-denoma is appropriate1. Hybrid lesions include compactporoid cells with prominent ductal differentiation havebeen referred to as poroid hidradenomas1. The clear cellscontain glycogen and periodic acid-Schiff-positive, dia-stase-resistant material, but no lipid5. The squamoidcells are polygonal with a central vesicular nuclei and aneosinophilic cytoplasm, often arranged in whorls1. Theymay even be cornified with formation of horn pearls6.Mucinous cells are the least common component. Theseare large cells with fine basophilic granular cytoplasm,cuboidal or columnar in shape. The cells line the tubulesand may show evidence of apocrine differentiation. Tran-sition between different types of cells is frequent. Whenwe reviewed cytology smears we noted two types of thecells, corresponding to the description above. Cellularsmears revealed large cohesive three-dimensional papil-lary-like clusters of dense packing cuboidal epithelialcells and middle sized, flatter clusters of cells with abun-dant, partially clear cytoplasm. As the quantity of differ-ent cells type vary markedly in different tumours, onemust be aware of the resemblance to metastatic renal cellcarcinoma, squamous cell carcinoma or signet-ring ade-nocarcinoma4,5. In the case of apocrine hidradenomawith pseudopapillary cell clusters, metastases of papil-lary carcinoma must be excluded7. The nuclear groovingrecently described as a common finding in these tu-mours, also confirmed by electron microscopy6 hasn’tbeen noticed in our case.The nuclei of neoplastic cells may be hyperchromatricand exhibit coarsely clumped chromatin, but presence ofmarked pleomorphism and frequent or atypical mitosesis not observed3. In our case we have seen mild hyper-chromasia, anizonucleosis and overlapping nuclei withsmall distinct nucleoli. Some authors describe mild pleo-morphism, multinucleation and occasional mitotic fig-ures in rare case of recurrent poroid hidradenoma8. Closefollow-up is necessary because histology is not always areliable indicator of biologic behaviour9.The hidradenoma often has cystic spaces that maycontain eosinophilic, homogenous material as a result ofdegeneration of the tumour cells6. That material shouldnot be mistaken for tumorous diathesis which with an-other features of malignancy like aggresive local growth,pleomorphism, numerous mitotic figures, angiolympha-tic and perineural invasion lead to diagnosis of hidrade-nocarcinoma5,6,9,10. Most of malignant forms of nodularhidradenoma are malignant from their inception, butsome develop from benign hidradenoma6. The hidrade-nocarcinomas are rare and tend to be moderate size, buta growth rate of both malignant and benign tumours isslow. Cytologic features indicative for malignancy may notbe obvious. Futher, in differential diagnosis we shouldconsider other primary appendageal benign and malig-nant tumours same as other malignant skin tumours likea basal cell carcinoma, Merkel cell carcinoma or malig-nant melanoma2,8,11.The PAS stain with diastase digestion were done addi-tionally on a residual smears. We demonstrated a posi-tivity in the cytoplasm of the clear cells as other authorsclaimed8,11. Hidradenomas could react with different mo-noclonal antibodies such as: citokeratin, specially CKLMW, EMA, CEA, S-100 protein, vimentin3,5.Complete excision is usually curative, but hidrade-noma may occasionally recure after local excision1,3. Thefirst case of nodular hidradenoma diagnosed by fine-nee-dle aspiration cytology was reported in 199612. Knowl-edge of the cytologic features of primary skin adnexalneoplasms helps distinguish them from the cutaneousmetastases which were more commonly referred forFNAC evaluation. Detailed clinical history, physical find-ings, and ancillary studies are essential add for correctdiagnosis. Even more skill is required to recognize spe-cific entities in a broad group of appendageal tumours.Considering that hidradenoma is an uncommon tumourand an experience in FNAC of such lesions is insufficient,we hope we made a useful contribution with this report.ConclusionDespite the fact that we missed the correct diagnosis,FNAC determined the need for surgical excision andN. P. Novak et al.: FNAC of Apocrine Hidradenoma, Coll. Antropol. 34 (2010) 2: 671–674673Fig. 5. The apocrine cells with eosinophilic cytoplasm andclear cells (MGG, x1000).Fig. 6. The cytochemical PAS-D reaction demonstrated thestrongest positivity in the clear cells (x1000).histologic evaluation. We belive that cytologic findings ofthree-dimensional papillary-like clusters with mild aty-pia, two types of cells and specific background in smearsof cutaneous nodule might be a lead to the diagnosis ofhidradenoma, but primary or secondary malignant tu-mour has been ruled out first.R E F E R E N C E S1. LEBOIT PE, Appendageal skin tumours. In: LEBOIT PE, BURGG, WEEDON D, SARASIN A (Eds) WHO Classification of Tumours, Pa-thology and Genetics: Skin Tumours, (IARC, Lyon, 2006). — 2. LAYFI-ELD LJ, MOONEY E, Acta Cytol, 42 (1998) 1064. — 3. RAGSDALE BD,MURPHY GF, Tumors of the skin. In: SILVERBERG SG, DELELLIS RA,FRABLE WJ (Eds). Principles and practice of surgical pathology and cy-topathology (Churchill Livingstone, New York, 1997). — 4. MANNION E,MCLAREN K, AL-NAFUSSI AI, Cytopathology, 6 (1995) 100. — 5. VOL-MAR KE, CUMMINGS TJ, WANG WH, CREAGER AJ, TYLER DS, XIEHB, Arch Pathol Lab Med, 129 (2005) 113. — 6. KHURSHID A, YAQOOBN, DEVAN HA, PERVEZ S, J Cutan Pathol, 34 (2007) 871. — 7. PÉREZ--GUILLERMO M, SOLANO JG, Diagn Cytopathol, 30 (2004) 275. — 8.HOSHIDA Y, HANAI J, MATSUSHITA N, YONEKAWAM, KOBAYASHIY, KAWAKAMI H, UCHINO N, AOZASA K, Acta Cytol, 42 (1999) 471. —9. HOLDEN B, COLOME-GRIMMER M, SAVAGE C, STIERMAN K,POU AM, Ear Nose Throat J, 81 (2002) 352. — 10. POHAR-MARIN[EK@, LAMOVEC J, Acta Dermatoven APA, 12 (2003) 94. — 11. CHO S, KIMJS, SHIN JH, KIM JH, KIM HJ, WHANG KK, HAHM JH, Int J Der-matol, 40 (2001) 62. — 12. GOTTSCHALK-SABAG S, GLICK T, DiagnCytopathol, 15 (1996) 395.N. P. NovakDepartment of Clinical Cytology and Cytometry, Dubrava University Hospital, Av. G. [u{ka 6, 10040 Zagreb, Croatiae-mail: dr.nina.novak@gmail.comCITOLO[KA PUNKCIJA APOKRINOG HIDRADENOMAS A @ E T A KApokrini hidradenom je benigna novotvorina ko`nih adneksa, naj~e{}e prekrivena nepromijenjenom ko`om. Pone-kad na ko`i mo`e biti izra`en povr{inski vrijed sa seroznim iscjetkom, obilje`je koje budi sumnju u zlo}udnost pro-mjene, {to je bio slu~aj i u na{eg bolesnika. Opisali smo citomorfolo{ke zna~ajke punktiranog ko`nog ~vora koje mogupomo}i u citolo{koj dijagnozi hidradenoma, uz preduvjet da su isklju~ene mogu}e primarne i sekundarne zlo}udnenovotvorine.N. P. Novak et al.: FNAC of Apocrine Hidradenoma, Coll. Antropol. 34 (2010) 2: 671–674674

Fine-Needle Aspiration Cytology of Apocrine Hidradenoma

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