Trichilemmal cysts with proteinaceous material: A potential diagnostic pitfall.
clear-cell hidradenoma
poroid hidradenoma
trichilemmal cyst
trichilemmal keratinization
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:
Jun 2022
Jun 2022
Historique:
revised:
08
01
2022
received:
16
06
2021
accepted:
10
02
2022
pubmed:
16
2
2022
medline:
21
5
2022
entrez:
15
2
2022
Statut:
ppublish
Résumé
Cysts of the skin are observed frequently and their diagnoses are generally straightforward. However, atypical cystic lesions for which differentiation is indistinct have been noted. We examined five cases of trichilemmal cyst with proteinaceous material (TCPM), which required differentiation from sweat duct/gland tumors. We investigated the histopathological findings of TCPMs and evaluated the immunohistochemical expression of cytokeratin (CK) 10, CK13, CK17, CK19, CD8, and CD117. Immunohistochemical analysis was performed on the 5 TCPMs, 10 trichilemmal cysts (TCs), 5 clear-cell hidradenomas, 5 poroid hidradenomas, and cutaneous normal adnexa. Apoptotic cells were present in the cyst wall with a small amount of keratin or calcification in the cavity of TCPMs. The TCPMs and TCs were negative for CK19 and CD117, on the other hand clear-cell hidradenoma and poroid hidradenoma were positive for CK19 and CD117. The restricted positivity for CK10 was detected in the suprabasal layers of the cyst walls of TCPMs and TCs. The immunostaining patterns of TCPMs and TCs were similar to those of normal follicular isthmus. The histopathological findings with characteristics of TCs and a panel of immunohistochemical antibodies including CD117, CK19, and CK10 contributed to a correct diagnosis of TCPM.
Sections du résumé
BACKGROUND
BACKGROUND
Cysts of the skin are observed frequently and their diagnoses are generally straightforward. However, atypical cystic lesions for which differentiation is indistinct have been noted.
METHODS
METHODS
We examined five cases of trichilemmal cyst with proteinaceous material (TCPM), which required differentiation from sweat duct/gland tumors. We investigated the histopathological findings of TCPMs and evaluated the immunohistochemical expression of cytokeratin (CK) 10, CK13, CK17, CK19, CD8, and CD117. Immunohistochemical analysis was performed on the 5 TCPMs, 10 trichilemmal cysts (TCs), 5 clear-cell hidradenomas, 5 poroid hidradenomas, and cutaneous normal adnexa.
RESULTS
RESULTS
Apoptotic cells were present in the cyst wall with a small amount of keratin or calcification in the cavity of TCPMs. The TCPMs and TCs were negative for CK19 and CD117, on the other hand clear-cell hidradenoma and poroid hidradenoma were positive for CK19 and CD117. The restricted positivity for CK10 was detected in the suprabasal layers of the cyst walls of TCPMs and TCs. The immunostaining patterns of TCPMs and TCs were similar to those of normal follicular isthmus.
CONCLUSIONS
CONCLUSIONS
The histopathological findings with characteristics of TCs and a panel of immunohistochemical antibodies including CD117, CK19, and CK10 contributed to a correct diagnosis of TCPM.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
515-524Subventions
Organisme : Nara Medical University Grant-in-Aid for Young Scientists
Informations de copyright
© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Références
Perez-Munoz N, Llamas-Velasco M, Castillo-Capponi G, et al. Dermatopathology of cutaneous cystic lesions: a practical review with diagnostic clues and pitfalls. Am J Dermatopathol. 2019;41(11):783-793.
Broekaert D, Goeman L, Ramaekers FC, et al. An investigation of cytokeratin expression in skin epithelial cysts and some uncommon types of cystic tumours using chain-specific antibodies. Arch Dermatol Res. 1990;282(6):383-391.
Kamyab K, Kianfar N, Dasdar S, Salehpour Z, Nasimi M. Cutaneous cysts: a clinicopathologic analysis of 2,438 cases. Int J Dermatol. 2020;59(4):457-462.
Pinkus H. "Sebaceous cysts" are trichilemmal cysts. Arch Dermatol. 1969;99(5):544-555.
Leppard BJ, Sanderson KV. The natural history of trichilemmal cysts. Br J Dermatol. 1976;94(4):379-390.
Resnik KS, DiLeonardo M. Epithelial remnants of isthmus-catagen cysts. Am J Dermatopathol. 2004;26(3):194-199.
Moll R, Franke WW, Schiller DL, Geiger B, Krepler R. The catalog of human cytokeratins: patterns of expression in normal epithelia, tumors and cultured cells. Cell. 1982;31(1):11-24.
Bosch FX, Leube RE, Achtstatter T, Moll R, Franke WW. Expression of simple epithelial type cytokeratins in stratified epithelia as detected by immunolocalization and hybridization in situ. J Cell Biol. 1988;106(5):1635-1648.
Heid HW, Moll I, Franke WW. Patterns of expression of trichocytic and epithelial cytokeratins in mammalian tissues. I. Human and bovine hair follicles. Differentiation. 1988;37(2):137-157.
Lyle S, Christofidou-Solomidou M, Liu Y, Elder DE, Albelda S, Cotsarelis G. The C8/144B monoclonal antibody recognizes cytokeratin 15 and defines the location of human hair follicle stem cells. J Cell Sci. 1998;111(Pt 21):3179-3188.
Li HH, Zhou G, Fu XB, Zhang L. Antigen expression of human eccrine sweat glands. J Cutan Pathol. 2009;36(3):318-324.
Misago N, Takai T, Toda S, Narisawa Y. The changes in the expression levels of follicular markers in keratoacanthoma depend on the stage: keratoacanthoma is a follicular neoplasm exhibiting infundibular/isthmic differentiation without expression of CK15. J Cutan Pathol. 2014;41(5):437-446.
Goto K. Immunohistochemistry for CD117 (KIT) is effective in distinguishing cutaneous adnexal tumors with apocrine/eccrine or sebaceous differentiation from other epithelial tumors of the skin. J Cutan Pathol. 2015;42(7):480-488.
Mason DY, Cordell JL, Gaulard P, Tse AG, Brown MH. Immunohistological detection of human cytotoxic/suppressor T cells using antibodies to a CD8 peptide sequence. J Clin Pathol. 1992;45(12):1084-1088.
Evangelista MT, North JP. MYB, CD117 and SOX-10 expression in cutaneous adnexal tumors. J Cutan Pathol. 2017;44(5):444-450.
Yamamoto O, Hisaoka M, Yasuda H, Kasai T, Hashimoto H. Cytokeratin expression of apocrine and eccrine poromas with special reference to its expression in cuticular cells. J Cutan Pathol. 2000;27(7):367-373.
Jih DM, Lyle S, Elenitsas R, Elder DE, Cotsarelis G. Cytokeratin 15 expression in trichoepitheliomas and a subset of basal cell carcinomas suggests they originate from hair follicle stem cells. J Cutan Pathol. 1999;26(3):113-118.
Kazakov DV, Michal M, Kacerovska D, McKee PH. Cutaneous Adnexal Tumors. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2012:312-314.
Torous VF, Su A, Binder SW, Ra SH. A rare case of a pilar cyst with ductal differentiation. Am J Dermatopathol. 2015;37(12):906-907.
Khan I, Fraga GR, Dai H. Trichilemmal cysts with divergent ductal differentiation: a series of 4 cases. Am J Dermatopathol. 2021;43(7):493-496.
Sau P, Graham JH, Helwig EB. Proliferating epithelial cysts. Clinicopathological analysis of 96 cases. J Cutan Pathol. 1995;22(5):394-406.
Saida T, Oohara K, Hori Y, Tsuchiya S. Development of a malignant proliferating trichilemmal cyst in a patient with multiple trichilemmal cysts. Dermatologica. 1983;166(4):203-208.
Park JS, Ko DK. A histopathologic study of epidermoid cysts in Korea: comparison between ruptured and unruptured epidermal cyst. Int J Clin Exp Pathol. 2013;6(2):242-248.