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Schweißdrüsentumoren mit apokriner und ekkriner Differenzierung

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Histopathologie der Haut

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Zusammenfassung

Einige der bekannten Schweißdrüsenkarzinome können sich aus benignen vorbestehenden Schweißdrüsentumoren entwickeln. Daher ist die Kenntnis des morphologischen Spektrums dieser Tumoren erforderlich, um den Übergang in ein Karzinom diagnostizieren zu können. Wichtige Malignitätskriterien sind zunehmende zytologische Atypien, Mitosen,Nekrosen, ein infiltrierendes Tumorwachstum mit perineuralen Tumorausläufern und intralymphatische Tumorzellen. Besondere Vorsicht ist insbesondere bei der Diagnostik des mikrozystischen Adnexkarzinoms angebracht. Da zytologische Malignitätskriterien fehlen und kaum Mitosen nachweisbar sind, ist es histologisch erforderlich, das infiltrierende Wachtumsmuster als wichtigstes und manchmal alleiniges Malignitätskriterium darzustellen. Die Diagnostik gelingt nur bei ausreichend tiefen Biopsien. Oberflächliche Biopsien, die es nicht gestatten, das Wachstumsmuster zu beurteilen, sollten nicht dazu verleiten, voreilig einen gutartigen Schweißdrüsentumor zu diagnostizieren.

Das digitale papilläre Adenokarzinom stellt ein breites Tumorspektrum dar mit vermeintlich gutartigen Läsionen auf der einen Seite und klaren Karzinomen auf der anderen Seite. Nur die genaue Kenntnis dieses Spektrums gestattet es, mit ausreichender diagnostischer Sicherheit die gutartig wirkenden Tumoren als Karzinome zu diagnostizieren.

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  1. Dermatopathologie Friedrichshafen, Siemensstr. 6/1, 88048, Friedrichshafen, Deutschland

    A. Rütten

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Editors and Affiliations

  1. Universitätsklinik für Dermatologie, Medizinische Universität Graz, Graz, Austria

    Lorenzo Cerroni

  2. Universitäts-Hautklinik, Eberhard-Karls-Universität, Tübingen, Germany

    Claus Garbe

  3. Universitäts-Hautklinik Münster, Münster, Germany

    Dieter Metze

  4. Dermatopathologie Friedrichshafen, Friedrichshafen, Germany

    Heinz Kutzner

  5. Universitätsklinik für Dermatologie und, Medizinische Universität Graz, Graz, Steiermark, Austria

    Helmut Kerl

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Rütten, A. (2016). Schweißdrüsentumoren mit apokriner und ekkriner Differenzierung. In: Cerroni, L., Garbe, C., Metze, D., Kutzner, H., Kerl, H. (eds) Histopathologie der Haut. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45133-5_32

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  • DOI: https://doi.org/10.1007/978-3-662-45133-5_32

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