Chondroid Syringoma: A Case with Unusual Cytological Findings
A 31-year-old male patient presented with a solitary 3 cm × 2.5 cm slowly growing, non-tender, cystic left supraorbital swelling [Figure and ]. It was fixed to the skin but freely mobile over underlying structures. The clinical diagnosis was sebaceous or epidermal cyst. FNAC yielded a thin fluid-like aspirate from which Leishman and Pap stained smears were prepared. Microscopic examination revealed moderately cellular smears composed of cohesive clusters of medium-sized epithelial cells with moderate to abundant amount of cytoplasm, peripheral cytoplasmic processes, and bland appearing monomorphic centrally placed or slightly eccentric nucleus with fine chromatin. Few clusters showed vague acinar formations. Smaller hyperchromatic myoepithelial cells were seen intimately admixed with the epithelial cells in most of the clusters []. Fair number of cyst macrophages, a thin proteinaceous material, and only rare chondromyxoid stromal fragments were detected in a predominantly clean background. A cytological diagnosis of benign cystic neoplasm possibly benign skin adnexal tumor was made and excision biopsy suggested.\nExcision biopsy was performed 2 weeks later. Histopathology revealed a chondroid syringoma with extensive cystic changes. Low power showed multiple well-circumscribed cystic spaces lined by tissue having biphasic growth pattern [] with epithelial elements in the form of non-branching bilayered tubules as well as solid nests embedded within a predominantly fibrous and focally chondromyxoid stroma. The cystic spaces contained scattered cyst macrophages. Differential diagnoses included eccrine hydrocystoma and syringocystadenoma papilliferum both of which lacked the distinctive chondromyxoid stromal element.