Paisley Tie Appearance

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A fanciful description of the histologic appearance of microcystic adnexal carcinoma (MAC) in which the nests of epithelial cells have a tadpole appearance. MAC is poorly circumscribed, deeply infiltrative and asymmetric, and has variable proportions of keratocysts, squamoid or basaloid nests, infiltrating cords, and ductular structures set in a variably hyalinised but usually paucicellular desmoplastic stroma
DiffDx Adenosquamous carcinoma, desmoplastic trichoepithelioma, eccrine epithelioma, metastases of breast and other carcinomas, morpheaform basal cell carcinoma, (poorly differentiated) squamous cell carcinoma, syringoma, trichoadenoma

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