Difference between revisions of "Dermal cysts"

From Libre Pathology
Jump to navigation Jump to search
(→‎Pilar cyst: split out)
(→‎Steatocystoma: split out)
Line 133: Line 133:
=Less common=
=Less common=
==Steatocystoma==
==Steatocystoma==
===General===
{{Main|Steatocytoma}}
*Benign.
*Typically adults.
*Usually on the trunk.
*May be genetic; known as ''steatocystoma multiplex''.<ref name=omim184500>{{OMIM|184500}}</ref>
**Classically autosomal dominant.<ref>URL: [http://path.upmc.edu/cases/case674/dx.html http://path.upmc.edu/cases/case674/dx.html]. Accessed on: 29 January 2012.</ref>
===Microscopic===
Features:<ref name=Ref_Derm312>{{Ref Derm|312}}</ref>
*Cyst lined by squamous epithelium with:
*#Corrugated eosinophilic lining - '''key feature'''.
*#*Similar appearance to compact keratin (hyperkeratosis).
*#*Described as a ''hyaline cuticle''.<ref>URL: [http://path.upmc.edu/cases/case674/dx.html http://path.upmc.edu/cases/case674/dx.html]. Accessed on: 29 January 2012.</ref>
*#'''No''' granular cell layer.


====Images====
<gallery>
Image:SkinTumors-P6260388.JPG | Steatocystoma. (WC)
Image:Steatocystoma_-_low_mag.jpg | Steatocystoma - low mag. (WC/Nephron)
Image:Steatocystoma_-_intermed_mag.jpg | Steatocystoma - intermed. mag. (WC/Nephron)
</gallery>
www:
*[http://www.flickr.com/photos/santoshpath/4788590105/in/photostream/ Steatocystoma - low mag. (flickr.com)].
**[http://www.flickr.com/photos/santoshpath/4788590109/ Steatocystoma - high mag. (flickr.com)].
*[http://path.upmc.edu/cases/case674/images/fig03.jpg Steatocystoma (upmc.edu)].<ref>URL: [http://path.upmc.edu/cases/case674.html http://path.upmc.edu/cases/case674.html]. Accessed on: 29 January 2012.</ref>
==Digital mucous cyst==
==Digital mucous cyst==
*[[AKA]] ''digital synovial cyst''.<ref name=dermpedia>URL: [http://www.dermpedia.org/dermpedia-textbook/digital-mucous-myxoid-cyst http://www.dermpedia.org/dermpedia-textbook/digital-mucous-myxoid-cyst]. Accessed on: 17 January 2012.</ref>
*[[AKA]] ''digital synovial cyst''.<ref name=dermpedia>URL: [http://www.dermpedia.org/dermpedia-textbook/digital-mucous-myxoid-cyst http://www.dermpedia.org/dermpedia-textbook/digital-mucous-myxoid-cyst]. Accessed on: 17 January 2012.</ref>

Revision as of 22:47, 16 February 2014

Dermal cysts, also skin cysts, are common in dermatopathology. Dermatopathologists can diagnose 'em.

Overview

Common types:[1]

Epidermal necrosis

Common cysts

Venous lake

General

  • Dilated vein.

Clinical:

  • Blanch with pressure.[2]

Gross

  • Purple/blue spot.

Images:

Microscopic

Features:[4]

  • Lined by endothelium.
  • Blood in lumen.
  • +/-Fibrin in lumen.
  • +/-Solar elastosis - very common.[5]

DDx:

Images:

Sign out

SKIN LESION, RIGHT CHEEK, BIOPSY:
- VENOUS LAKE.
- SOLAR ELASTOSIS.
- NEGATIVE FOR NEVUS.

Epidermal inclusion cyst

Main article: Epidermal inclusion cyst

Pilar cyst

  • AKA trichilemmal cyst.
Main article: Pilar cyst

Dermoid cyst

General

Microscopic

Features:[7][8]

  • Cyst lined by normal (keratinized) skin with adnexal structure (hair follicles, sweat glands, sebaceous glands).

DDx:

Images:

Sign out

OVARY AND UTERINE TUBE, LEFT, UNILATERAL SALPINGO-OOPHORECTOMY:
- MATURE TERATOMA.
- UTERINE TUBE WITHIN NORMAL LIMITS.
- NEGATIVE FOR MALIGNANCY.

Pilonidal cyst

  • AKA pilonidal sinus.
  • AKA pilonidal disease.[9]

General

  • Benign.
  • Young adults (late teens, early twenties) - usu. men.[10]

Gross

  • Usually at gluteal folds.
    • Uncommon: axilla, genital region, umbilicus, scalp.[11]

Microscopic

Features:[11]

DDx:

Sign out

SKIN LESION (PILONIDAL SINUS), EXCISION: 
- PILONIDAL SINUS.
- NEGATIVE FOR MALIGNANCY.

LESION (PILONIDAL SINUS), EXCISION:
- SKIN WITH PILONIDAL SINUS, CHRONIC INFLAMMATION AND SCARRING.
- NEGATIVE FOR MALIGNANCY.

Micro

The section shows hair-bearing skin with a deep sinus tract containing large clusters of neutrophils, abundant plasma cells, hemosiderin-laden macrophages, eosinophils and multinucleated giant cells. The core of the lesion is, focally, well-vascularized. At the edge of the lesion is fibrotic tissue with plump fibroblasts. Benign, fibrofatty tissue with scant inflammation completely surrounds the tract, in the plane of section; however, it is focally fragmented. There is no squamous lining within the sinus. No nuclear atypia is identified.

Alternate

The section shows hair-bearing skin with a deep sinus containing large clusters of neutrophils, abundant plasma cells, hemosiderin-laden macrophages and multinucleated giant cells. Benign fibrofatty tissue with scant inflammation completely surrounds the lesion in the plane of section. There is no squamous lining within the sinus. No nuclear atypia is identified.

Sinus versus cyst

The section shows hair-bearing skin with a cyst/sinus lined by benign squamous epithelium containing keratin. The surrounding dermis has a mixed inflammatory infiltrate, predominantly consisting of plasma cells and lymphocytes. Multinucleated giant cells are present. No significant nuclear atypia is identified.

Less common

Steatocystoma

Main article: Steatocytoma

Digital mucous cyst

General

Microscopic

Features:[13]

  • Mucous in superficial dermis - key feature.
  • No epithelial lining; it is a pseudocyst.

Note:

  • Mucin = glycolated proteins; may be part of mucous.
  • Mucous = slippery secretion.
    • Some split hairs over the "u" - "mucus" vs. "mucous".[14][15]

DDx:

Images:

Sign out

LESION, LEFT INDEX FINGER, EXCISION:
- DIGITAL MUCOUS CYST.

Apocrine cystadenoma

General

  • Uncommon.

Microscopic

Features:[17]

  • Multiloculated.
  • Apocrine differentiation: columnar epithelium +/- apical snouts.
  • Solid areas of epithelial proliferation.
  • Papillary projections into the cyst.

Images:

See also

References

  1. ↑ Greenwald, J.; Heng, M. (2007). Toronto Notes for Medical Students 2007 (2007 ed.). The Toronto Notes Inc. for Medical Students Inc.. pp. D5. ISBN 978-0968592878.
  2. ↑ URL: http://dermatlas.med.jhmi.edu/derm/IndexDisplay.cfm?ImageID=-969536424. Accessed on: 13 August 2012.
  3. ↑ 3.0 3.1 3.2 URL: http://dermatlas.med.jhmi.edu/derm/result.cfm?Diagnosis=605386295. Accessed on: 13 August 2012.
  4. ↑ Weedon's Skin Pathology. 3rd Ed. P.895.
  5. ↑ 5.0 5.1 Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 551. ISBN 978-0443066542.
  6. ↑ URL: http://www.dermpedia.org/case/70-year-old-woman-with-nose-lesion. Accessed on: 21 June 2013.
  7. ↑ 7.0 7.1 7.2 Gandhi N, Syed NA, Alen R. Dermoid Cyst. EyeRounds.org. posted July 26, 2010; Available from: http://www.EyeRounds.org/cases/115-dermoid-cyst.htm. Accessed on: 22 September 2011.
  8. ↑ Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 596. ISBN 978-1416054542.
  9. ↑ URL: http://emedicine.medscape.com/article/788127-overview. Accessed on: 10 September 2012.
  10. ↑ URL: http://www.nhs.uk/conditions/Pilonidal-sinus/Pages/Introduction.aspx. Accessed on: 10 September 2012.
  11. ↑ 11.0 11.1 Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 326. ISBN 978-0443066542.
  12. ↑ Chatzis, I.; Noussios, G.; Katsourakis, A.; Chatzitheoklitos, E.. "Squamous cell carcinoma related to long standing pilonidal-disease.". Eur J Dermatol 19 (4): 408-9. doi:10.1684/ejd.2009.0705. PMID 19482585.
  13. ↑ 13.0 13.1 13.2 13.3 URL: http://www.dermpedia.org/dermpedia-textbook/digital-mucous-myxoid-cyst. Accessed on: 17 January 2012.
  14. ↑ URL: http://dictionary.reference.com/browse/mucous. Accessed on: 8 January 2012.
  15. ↑ URL: http://dictionary.reference.com/browse/mucus. Accessed on: 8 January 2012.
  16. ↑ URL: http://www.dermpedia.org/case/digital-mucous-cyst-ganglion-type. Accessed on: 5 July 2013.
  17. ↑ Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 316. ISBN 978-0443066542.
Retrieved from "https://librepathology.org/w/index.php?title=Dermal_cysts&oldid=29446"