Giant chondroid syringoma with divergent differentiation: Cyto-histo-immuno correlation
A 50-year-old male presented with painless, progressively enlarging swelling over the lower back since 3 years. Examination revealed a firm non-tender swelling measuring 12 × 8 × 5 cm. Surface showed two nodules, largest measuring 6 × 5 × 4 cm and smallest 1.5 × 1 cm []. Aspiration yielded thick, mucoid, and gelatinous material.\nSmears showed cells arranged in loose cohesive clusters and in discretes, amidst which was chondromyxoid material []. Cells were round to oval, centrally located nuclei having fine chromatin with moderate to abundant cytoplasm, a few showed one to two prominent nucleoli [] consistent with chondroid syringoma.\nReceived a skin covered soft tissue mass which measured 14 × 9.5 × 4 cm. Skin measured 12.5 × 8.5 cm. External surface showed two nodules, largest measured 6 × 5 ×4 cm and smallest 1.5 × 1 cm. Cut surface revealed a lobulated mass showing grey white myxoid areas [].\nRevealed a well-demarcated neoplasm composed of round to oval cells arranged in sheets, tubuloalveolar, and branching cleft-like pattern. Tumor showed bands of eosinophilic material along with fibromyxoid stroma and chondroid areas. Areas showing lipomatous and clear cell changes [], cartilage [], osteoid bone formation [], and foci of calcification [] were also observed.\nThe tumor cells arranged in tubuloalveolar pattern showed expression of IHC markers. The inner layer of epithelial cells were positive for pancytokeratin (AE1 + AE2) [] and the outer layers expressed vimentin (V9) []. Mouse monoclonal antibodies manufactured by Biogenix were used for our study.