Digital mucous cyst: Altered epidermal mucin as a clue to diagnosis.
Aged
Alcian Blue
Biopsy
Cysts
/ diagnosis
Eosinophils
/ metabolism
Epidermis
/ metabolism
Exudates and Transudates
/ metabolism
Female
Fingers
/ pathology
Fluoresceins
Hematoxylin
Humans
Immunohistochemistry
/ methods
Keratinocytes
/ metabolism
Mucins
/ metabolism
Retrospective Studies
Staining and Labeling
/ methods
digital mucous cyst
hematoxylin
mucin
transepidermal elimination
Journal
Journal of cutaneous pathology
ISSN: 1600-0560
Titre abrégé: J Cutan Pathol
Pays: United States
ID NLM: 0425124
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
18
01
2020
revised:
10
03
2020
accepted:
23
03
2020
pubmed:
6
4
2020
medline:
5
8
2021
entrez:
6
4
2020
Statut:
ppublish
Résumé
Digital mucous cyst (DMC) is histopathologically characterized by accumulation of mucin in the dermis. Some cases of DMC also show epidermal mucin, the histopathologic appearance and staining properties of which have not been described in detail. A total of 24 cases of DMC were investigated by routine hematoxylin-eosin (H&E) and Alcian blue stains in addition to AE1/AE3 immunohistochemistry. Nine out of the 24 cases of DMC showed epidermal mucin. As the epidermal mucin migrates upward within the epidermis, it transforms from a flocculent granular substance into one or several solid horizontal plugs with a more homogeneous appearance and incorporates cytoplasmic fragments of keratinocytes/corneocytes. The homogeneous mucin plugs stain eosinophilic or amphophilic with an H&E formulation using hematoxylin 7212 and basophilic with Gill 3 or Harris's hematoxylin. The eosinophilic staining is enhanced when the eosin solution contains phloxine. The variably eosinophilic, amphophilic, or basophilic staining of epidermal mucin can be explained by its composition of basophilic mucin and eosinophilic debris from cytoplasmic fragments. The eosinophilic staining of mucin has not been reported before and can be diagnostically important because it may be mistaken for serum exudate.
Sections du résumé
BACKGROUND
BACKGROUND
Digital mucous cyst (DMC) is histopathologically characterized by accumulation of mucin in the dermis. Some cases of DMC also show epidermal mucin, the histopathologic appearance and staining properties of which have not been described in detail.
METHODS
METHODS
A total of 24 cases of DMC were investigated by routine hematoxylin-eosin (H&E) and Alcian blue stains in addition to AE1/AE3 immunohistochemistry.
RESULTS
RESULTS
Nine out of the 24 cases of DMC showed epidermal mucin. As the epidermal mucin migrates upward within the epidermis, it transforms from a flocculent granular substance into one or several solid horizontal plugs with a more homogeneous appearance and incorporates cytoplasmic fragments of keratinocytes/corneocytes. The homogeneous mucin plugs stain eosinophilic or amphophilic with an H&E formulation using hematoxylin 7212 and basophilic with Gill 3 or Harris's hematoxylin. The eosinophilic staining is enhanced when the eosin solution contains phloxine.
CONCLUSIONS
CONCLUSIONS
The variably eosinophilic, amphophilic, or basophilic staining of epidermal mucin can be explained by its composition of basophilic mucin and eosinophilic debris from cytoplasmic fragments. The eosinophilic staining of mucin has not been reported before and can be diagnostically important because it may be mistaken for serum exudate.
Substances chimiques
Fluoresceins
0
Mucins
0
Alcian Blue
P4448TJR7J
phloxine
QDW0T759T6
Hematoxylin
YKM8PY2Z55
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
705-709Informations de copyright
© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Références
Johnson WC, Graham JH, Helwig EB. Cutaneous myxoid cyst. A clinicopathological and histochemical study. JAMA. 1965;191(1):15-20.
Salasche SJ. Myxoid cysts of the proximal nail fold: a surgical approach. J Dermatol Surg Oncol. 1984;10(1):35-39.
Sonnex TS. Digital myxoid cysts: a review. Cutis. 1986;37(2):89-94.
Fernandez-Flores A. Transepidermal elimination of mucin is a very common but not yet reported phenomenon in digital myxoid cysts: a study of 35 cases. J Cutan Pathol. 2015;42(12):974-977.