papillary sweat gland adenoma
Introduction
Introduction to papillary sweat gland adenoma The papillary sweat gland adenoma (hidroadenomapapilliferum) is a tumor of the anus of the genital part of an adult woman. This disease is rare. The age of onset is mainly 25 to 40 years old, and the incidence of genital area is 4 times higher than that of the anal. basic knowledge The proportion of illness: the incidence rate is about 0.004% - 0.007% Susceptible people: women aged 25 to 40 Mode of infection: non-infectious Complications: sepsis
Cause
The cause of papillary sweat gland adenoma
Causes
Mainly due to the formation of epithelial hyperplasia of sweat glands, the exact cause is unknown, and may be related to the following factors: 1. Local long-term friction stimulation, spicy stimulation of food and fried foods and other bad living habits, leading to local epithelial cell changes, 2. May be related to genetic factors, genetic factors, leading to abnormal proliferation of local sweat gland cells. 3. Contact with radioactive sources, irritating substances, and inflammatory infections, etc., causing local cell variability.
Histopathology
Located in the dermis, the boundary is clear, surrounded by a fibrous capsule. In most cases, it is not connected to the epidermis. The duct and cystic structure are seen in the tumor. The papillary folds protrude into the cystic cavity. Rows of columnar cells, the nucleus is oval, lightly stained, as seen in the active phase of the apocrine gland secreting cells, and a small cuboid cell with deep basophilic nucleus is myoepithelial cells, histochemistry The cystic cells contain PAS-positive, amylase-resistant large particles as seen in apocrine cells, and cystic cells are positive for non-specific esterase and acid phosphatase and other apocrine enzymes, while phosphorylase is a small sweat gland. The enzyme is negative, and peripheral cells such as myoepithelial cells are alkaline phosphatase-positive. Electron microscopy can prove that cystic cells have two characteristics that are characterized by apocrine gland-secreting cells, one of which is a membrane of many different sizes and densities. Limiting secretory granules and lipid droplets on the tip of these cells, and second, as evidence of decapitation, large secretory granules in the apical tip of the cytoplasm are released into the sac cavity, surrounding Cells with a lot of muscle filaments.
Prevention
Papillary sweat gland adenoma prevention
1. Strengthen physical exercise, enhance physical fitness, and exercise more in the sun. Excessive sweating can excrete acidic substances in the body with sweat, avoiding the formation of acidic constitution. Have a good attitude to cope with stress, work and rest, do not fatigue. Visible pressure is an important cause of cancer. Chinese medicine believes that stress leads to excessive physical weakness, which leads to decreased immune function, endocrine disorders, metabolic disorders in the body, leading to the deposition of acidic substances in the body. Stress can also lead to mental stress causing qi stagnation and blood stasis. Invagination and so on.
2, do not eat too much salty and spicy food, do not eat foods that are overheated, too cold, expired and deteriorated; those who are frail or have certain genetic diseases should eat some cancer prevention foods and high alkali content as appropriate. Alkaline foods, maintain a good mental state to develop good habits, stop smoking and limit alcohol. Smoking, the World Health Organization predicts that if people no longer smoke, after five years, the world's cancer will be reduced by 1/3; secondly, no alcohol. Smoke and alcohol are extremely acidic and acidic substances. People who smoke and drink for a long time can easily lead to acidic body. Finding timely treatment of the disease is key.
Complication
Papillary sweat gland adenoma complications Complications sepsis
This disease can be associated with superficial ulcers of the vulva, often accompanied by obvious itching of the vulva, scratching can cause further skin rupture, skin integrity is destroyed, it can be caused by skin scratching or fungal infection caused by scratching, usually secondary to Patients with low constitution, long-term use of immunosuppressants and fungal infections such as onychomycosis, such as concurrent bacterial infections may have fever, skin swelling, ulceration and purulent secretion. Severe cases can lead to sepsis, which should be brought to the attention of clinicians.
Symptom
Papillary sweat gland adenoma symptoms common symptoms nodular granuloma
The tumor is round and can move freely from high height. It is solid, soft or cystic. It is 1~40mm in size and occurs in the labia majora. It can also occur in other parts of the female genital area or in the perianal area. Other parts are rare. Generally, there are no symptoms, sometimes tenderness or bleeding, occasionally ulceration on the surface, valgus into a reddish-brown papillary mass and suspected of being a malignant tumor.
Examine
Examination of papillary sweat gland adenoma
First, the secretion check:
The secretions are purulent, with most of the bacteria. Seriously infected people may have stench.
Second, blood routine:
An increase in white blood cell count can be found.
Third, histopathological examination:
The wall of the microscopic examination is fibrous tissue with squamous epithelial lining and keratinized material. Foreign body reactive giant cells are visible in the fibrous tissue of the wall of the capsule.
Fourth, image inspection:
1, CT performance:
A uniform or uneven low-density change with a CT value of 0-15HU and a clear edge.
2, MR performance:
Enhanced inspection has no strengthening effect.
Histopathology:
Located in the dermis, the boundary is clear, surrounded by a fibrous capsule. In most cases, it is not connected to the epidermis. The duct and cystic structure are seen in the tumor. The papillary folds protrude into the cystic cavity. Rows of columnar cells, the nucleus is oval, lightly stained, as seen in the active phase of the apocrine gland secreting cells, and a small cuboid cell with deep basophilic nucleus is myoepithelial cells, histochemistry The cystic cells contain PAS-positive, amylase-resistant large particles as seen in apocrine cells, and cystic cells are positive for non-specific esterase and acid phosphatase and other apocrine enzymes, while phosphorylase is a small sweat gland. The enzyme is negative, and peripheral cells such as myoepithelial cells are alkaline phosphatase-positive. Electron microscopy can prove that cystic cells have two characteristics that are characterized by apocrine gland-secreting cells, one of which is a membrane of many different sizes and densities. Limiting secretory granules and lipid droplets on the tip of these cells, and second, as evidence of decapitation, large secretory granules in the apical tip of the cytoplasm are released into the sac cavity, surrounding Cells with a lot of muscle filaments.
Diagnosis
Diagnosis and differentiation of papillary sweat gland adenoma
diagnosis
According to the clinical manifestations, the characteristics of skin lesions and histopathological features can be diagnosed.
Differential diagnosis
Mainly differentiated from tubular apocrine sweat gland adenoma, the latter can be seen in the apical secretion, but sometimes the two are difficult to distinguish, Falck and Jordan collectively called it "catheter papillary sweat adenoma", indicating the apocrine sweat gland and eccrine sweat glands Differentiate to represent these two tumors, respectively.
