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Trichilemmal Cysts With Divergent Ductal Differentiation: A Series of 4 Cases.
- Source :
-
The American Journal of dermatopathology [Am J Dermatopathol] 2021 Jul 01; Vol. 43 (7), pp. 493-496. - Publication Year :
- 2021
-
Abstract
- Abstract: Trichilemmal cysts are common clonal tumors with a predilection for the scalp. They are composed of an outer epithelial wall resembling the outer root sheath in the isthmus of the hair follicle and a central core of compact keratin. Sweat duct differentiation is exceptional with only one convincing case reported to date. Here, we sought to characterize the clinicopathological characteristics of sweat duct differentiation in trichilemmal cysts. We reviewed all cases of trichilemmal cyst diagnosed at our institution between 2008 and 2019. Ductal structures were found in 4 of 411 cases (0.97%). Subjects included 2 male and 2 female patients with a median age of 37.5 years (range 34-55). The ducts were lined by attenuated epithelial cells and immunoreactive for polyclonal carcinoembryonic antigen and cytokeratin 7. Ductal differentiation involved a median of 7.5% (range 1%-50%) of the cyst wall. All 4 cases were from the scalp and treated with local excision. No recurrence was identified with a median follow-up period of 1.5 years (range 1-12 years). In summary, sweat duct differentiation in trichilemmal cysts is rare but likely under recognized. Conceptually, we suggest it represents a type of divergent cellular differentiation within a clonal neoplasm rather than a retention cyst or hybrid cyst.<br />Competing Interests: The authors declare no conflicts of interest.<br /> (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)
- Subjects :
- Adult
Carcinoembryonic Antigen analysis
Epidermal Cyst chemistry
Epidermal Cyst surgery
Female
Humans
Keratin-7 analysis
Male
Middle Aged
Retrospective Studies
Scalp chemistry
Scalp surgery
Scalp Dermatoses metabolism
Scalp Dermatoses surgery
Sweat Glands chemistry
Sweat Glands surgery
Treatment Outcome
Cell Differentiation
Epidermal Cyst pathology
Scalp pathology
Scalp Dermatoses pathology
Sweat Glands pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1533-0311
- Volume :
- 43
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- The American Journal of dermatopathology
- Publication Type :
- Academic Journal
- Accession number :
- 33201018
- Full Text :
- https://doi.org/10.1097/DAD.0000000000001839