Chondroid syringoma: Cytomorphology of four cases and review of literature

Introduction: Chondroid syringoma also known as benign mixed tumor of the skin presents as a slow growing, painless dermal/subcutaneous nodule. The cytological features of this entity have been rarely described, and are limited to a few case reports. The present study emphasizes on the cytological features of chondroid syringoma on fine needle aspiration (FNA). Materials and Methods: A retrospective analysis of all cases of chondroid syringoma diagnosed/missed on fine needle aspiration (FNA) with subsequent histopathologic confirmation over a period of five years (2011-2015) was undertaken. FNA was done using a 23 gauge needle fitted to a 10 mL syringe mounted on Franzen’s handle. Chondroid syringoma was diagnosed on cytology in 3 cases of which 2 were confined to head and neck region while 1 was in axilla. One case was misdiagnosed as fibroadenoma with secondary myxoid change on cytology. Results: Case 1 was a 57-year-old man with a nodule in left axilla. Case 2 was a 52-year-old woman who presented with a nodule on tip of the nose. Case 3 was a 46-year-old man with nodule on upper lip. Case 4 was a 38-year-old lady with lump breast. FNA smears were cellular in all the cases and showed clusters of cells embedded in chondromyxoid stroma. Cells were round to oval with bland nuclear features and moderate amount of cytoplasm. Plentiful of chondromyxoid material was seen in the background. No cytological atypia/mitosis/necrosis was seen. Conclusions: Chondroid syringoma can undoubtedly be diagnosed on FNA. Cytologic smears are reminiscent of pleomorphic adenoma of salivary gland. Rarity of this adnexal tumor may be responsible for the diagnosis being missed on evaluation of aspirates.