Chondroid syringa: causes, symptoms, diagnosis, treatment

Chondroid syringoma (syn: mucinous hydratenoma, the so-called mixed skin tumor) occurs mainly in men, can be observed in different parts of the body, but more often on the scalp, face and neck. Tumor in the form of a small nodule located either in the dermis, or somewhat protrudes above the surface of the skin, its surface is smooth, sometimes with a translucent wall, occasionally ulcerated. When palpation, the tumor has a tight elastic consistency. Growth is slow, can last for years. It resembles a cystic basal cell.

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Pathomorphology of chondroid syringoma

The histological structure of the tumor is quite diverse, but in all cases the epithelial component and the proliferation of connective tissue with symptoms of myxomatosis occur, often with the formation of chondroid parts. The ratio of epithelial and connective tissue components varies widely. WF Lever and G. Schaumburg-Lever (1983) distinguish two histological types of the epithelial component: tubular and cystic. The tumor of the tubular type consists of numerous narrow cords with ramifications lying in the hyaline-mucinous stroma. The lumens of the tubular structures are lined with two layers of epithelial cells: some of them are in the lumen, have a prismatic shape, others (on the periphery) are flat. In the mucoid stroma, in addition, single or conglomerate proliferating flat cells are found. In most cases, the lumens of the tubular structures contain an amorphous eosinophilic Schick-positive diastase-resistant substance.

Cystic type of tumor consists mostly of small cystic cavities, as well as small groups and strands of epithelial cells. Their lumen is covered with only one layer of flat epithelial cells, from which the proliferates in the form of "tails" leave the stroma. The stroma of the tumor is basophilic, contains mucoid substances. The fibroblasts and individual epithelial cells in it have a light halo, which resembles cartilage cells. When staining with toluidine blue, metachromasia is observed, resistant to hyaluronidase, which indicates the presence of chondroitin sulfates in the tumor.

Histogenesis of chondroid syringoma

With the help of electron microscopy ekrinnaya differentiation of this tumor has been proved. The inner cells of the tubular structures resemble the dark and light cells of the terminal sections of the eccrine glands, and the outer flat cells are myoepithelial, since they contain a large number of filaments and are distributed inside the chondroid matrix produced by them.

Differential diagnosis is based on the presence in this tumor of adenoid and epithelial strands, as well as chondroid cells in the mucinous stroma. The mixed swelling of the salivary glands has only a morphological similarity with the chondroid syringoma, but their histogenesis is different.