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June 2004

A Rare, Rapidly Growing Purple Tumor on the Cheek—Diagnosis

Author Affiliations


Arch Dermatol. 2004;140(6):751. doi:10.1001/archderm.140.6.751-f

Microscopic examination showed a well-circumscribed dermal neoplasm with solid and cystic areas. The solid areas were composed of a mixture of epithelium and stroma in varying proportions. In some areas, the epithelium was arranged in solid sheets, often with a whorled appearance, interrupted by cystic degeneration, which in some cases resulted in the formation of large cystic spaces. The cells were polygonal and monomorphic and sometimes had a plasmacytoid appearance. There were also a few cells with larger hyperchromatic nuclei, which were interpreted as degenerate. Mitotic activity was present but low. In other areas, ductal differentiation was much more obvious, typically seen as a lining of 2 layers of eosinophilic columnar cells, with the luminal layer often showing apocrine blebbing. Proteinaceous secretions were present in the lumina. The stromal component showed a mixture of fibrous tissue and conspicuous adipose tissue. Also, some areas showed prominent myxoid change and unequivocal chondroid differentiation. Taken together, the features were typical of a chondroid syringoma.

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