PMC3997245_01
Cystic-solid tumour in dermis with areas of necrosis (A) (H&E, x100). Vacuolated bubbly cytoplasm of tumour cells (B) (H&E, x400). [Copyright:  2012 Panjwani et al.]
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Histology revealed a cystic-solid tumour in the dermis (Figure 1A). Necrosis was present (Figure 1A).
Nodular mass in the axilla with puckering of the skin (A+B). FNAC showing tumour cells with plasmacytoid morphology (C) (H&E, x400). Nests of vacuolated cells separated by fibrous septae (D) (H&E, x200). [Copyright:  2012 Panjwani et al.]
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The axillary skin was puckered and the mass was palpable (Figures 2A, 2B). Fine needle aspiration of the mass showed a neoplasm with plasmacytoid morphology (Figure 2C). A few cells showed cytoplasmic vacuoles (Figure 2D).
PMC3997245_02
Nodular mass in the axilla with puckering of the skin (A+B). FNAC showing tumour cells with plasmacytoid morphology (C) (H&E, x400). Nests of vacuolated cells separated by fibrous septae (D) (H&E, x200). [Copyright:  2012 Panjwani et al.]
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The axillary skin was puckered and the mass was palpable (Figures 2A, 2B). Fine needle aspiration of the mass showed a neoplasm with plasmacytoid morphology (Figure 2C). A few cells showed cytoplasmic vacuoles (Figure 2D).
Varied morphology and patterns of the tumour cells: solid nests (A), comedonecrosis (B) and cords with hyalinisation (C) (H&E x10). IHC for EMA showing characteristic vacuolated cytoplasm in tumour cells (D) (EMA, x400). [Copyright:  2012 Panjwani et al.]
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EMA (epithelial membrane antigen) and focally for CD 15. EMA staining showed a bubbly, vacuolated cytoplasm in many cells, highlighting their sebocytic nature (Figure 3D). There were varying architectural patterns, such as solid nests (Figure 3A), areas with comedo-necrosis (Figure 3B), and thick cords with hyalinisation (Figure 3C).
PMC3997245_03
Nodular, plaque-like lesions on anterior chest wall (A). FNAC showing a poorly differentiated carcinoma (B) (H&E, x200). Nested tumour cells in dermis (C) (H&E, x40). Pagetoid spread of cells showing sebocytic differentiation (D) (H&E, x100). IHC for EMA highlighting the vacuolated, bubbly cytoplasm. (E) (EMA, x400). [Copyright:  2012 Panjwani et al.]
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A 78-year-old lady presented to the FNAC clinic of our hospital with history of erythematous nodular and plaque-like lesions measuring 6 x 4 cm on the right anterior chest wall (Figure 4A). Fine needle aspiration from the nodule showed a poorly differentiated carcinoma (Figure 4B). A tumour was seen in the dermis with the characteristic morphology of sebaceous carcinoma (Figure 4C) and a prominent pagetoid spread (Figure 4D). Sebocytic vacuolated cells were highlighted by the EMA stain (Figure 4E).