Epidermoid cyst: Difference between revisions
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→Differential diagnosis: Expanded |
→Microscopic evaluation: Enough |
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==Microscopic evaluation== | ==Microscopic evaluation== | ||
[[File:Histopathology of epidermoid cyst.jpg|thumb|Epidermoid cyst]] | [[File:Histopathology of epidermoid cyst.jpg|thumb|Epidermoid cyst]] | ||
[[File:Histopathology of ruptured epidermoid cyst.jpg|thumb|A '''ruptured epidermoid cyst''', with a foreign body reaction including multinucleated giant cells, surrounding keratin fragments. A cyst wall is not necessary for diagnosis in a clinical context of skin cyst.]] | |||
Typical findings:<ref>{{cite web|url=http://www.pathologyoutlines.com/topic/skintumornonmelanocytickeratinouscystepidermal.html|title=Skin nonmelanocytic tumor - Cysts - Epidermal (epidermoid) type|author= V. Claire Vaughan, M.D., Joshua Wisell, M.D.|website=pathology Outlines}} Topic Completed: 9 May 2019. Revised: 13 December 2019</ref> | Typical findings:<ref>{{cite web|url=http://www.pathologyoutlines.com/topic/skintumornonmelanocytickeratinouscystepidermal.html|title=Skin nonmelanocytic tumor - Cysts - Epidermal (epidermoid) type|author= V. Claire Vaughan, M.D., Joshua Wisell, M.D.|website=pathology Outlines}} Topic Completed: 9 May 2019. Revised: 13 December 2019</ref> | ||
*Stratified squamous epithelium with a granular layer | *Stratified squamous epithelium with a granular layer | ||
Latest revision as of 08:42, 27 September 2021
Author:
Mikael Häggström [note 1]
Generally presents as a skin cyst. Also known as epidermal inclusion cyst (EIC) and sebaceous cyst.
Microscopic evaluation
Typical findings:[1]
- Stratified squamous epithelium with a granular layer
- Cyst wall does not contain eccrine glands, sebaceous glands or hair follicles
- Abundant keratin flakes in cyst lumen
- Often giant cell granuloma in ruptured cysts, similar to foreign body granuloma
Differential diagnosis
Mainly:
-
![Trichilemmal cyst, containing, from external (top) to internal (bottom):[image 1][2] - Fibrous capsule - Small, cuboidal, dark-staining basal epithelial cells in a palisade arrangement, with no distinct intercellular bridging - Swollen pale keratinocytes, which increase in height closer to the interior - Solid eosinophilic-staining keratin There is no granular cell layer (in contrast to an epidermoid cyst).](https://upload.wikimedia.org/wikipedia/commons/thumb/5/5d/Histopathology_of_trichilemmal_cyst_-_annotated.jpg/330px-Histopathology_of_trichilemmal_cyst_-_annotated.jpg?utm_source=commons.wikimedia.org&utm_campaign=imageinfo&utm_content=thumbnail)
Trichilemmal cyst, containing, from external (top) to internal (bottom):[image 1][2]
- Fibrous capsule
- Small, cuboidal, dark-staining basal epithelial cells in a palisade arrangement, with no distinct intercellular bridging
- Swollen pale keratinocytes, which increase in height closer to the interior
- Solid eosinophilic-staining keratin
There is no granular cell layer (in contrast to an epidermoid cyst). -
![Pilomatricoma: Stroma surrounding irregularly shaped islands containing basaloid cells (darkly stained, round or elongated), which abruptly or gradually transitions into ghost cells (having pale cytoplasm and a central clear area), which in turn may transition into necrosis.[image 1][3]](https://upload.wikimedia.org/wikipedia/commons/thumb/2/2a/Histopathology_of_pilomatricoma%2C_high_magnification%2C_annotated.jpg/500px-Histopathology_of_pilomatricoma%2C_high_magnification%2C_annotated.jpg?utm_source=commons.wikimedia.org&utm_campaign=imageinfo&utm_content=thumbnail)
Pilomatricoma: Stroma surrounding irregularly shaped islands containing basaloid cells (darkly stained, round or elongated), which abruptly or gradually transitions into ghost cells (having pale cytoplasm and a central clear area), which in turn may transition into necrosis.[image 1][3]
![Trichilemmal cyst, containing, from external (top) to internal (bottom):[image 1][2] - Fibrous capsule - Small, cuboidal, dark-staining basal epithelial cells in a palisade arrangement, with no distinct intercellular bridging - Swollen pale keratinocytes, which increase in height closer to the interior - Solid eosinophilic-staining keratin There is no granular cell layer (in contrast to an epidermoid cyst).](/File:Histopathology_of_trichilemmal_cyst_-_annotated.jpg)
![Pilomatricoma: Stroma surrounding irregularly shaped islands containing basaloid cells (darkly stained, round or elongated), which abruptly or gradually transitions into ghost cells (having pale cytoplasm and a central clear area), which in turn may transition into necrosis.[image 1][3]](/File:Histopathology_of_pilomatricoma,_high_magnification,_annotated.jpg)
Further information: Skin cyst
Further workup
Look for signs of cyst rupture, which may manifest as inflammation, including granulomas and microabscesses.
Microscopic report
Example:
| Scalp skin cyst, excision: Ruptured epidermoid cyst. |
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
Main page
References
- ↑ V. Claire Vaughan, M.D., Joshua Wisell, M.D.. Skin nonmelanocytic tumor - Cysts - Epidermal (epidermoid) type. pathology Outlines. Topic Completed: 9 May 2019. Revised: 13 December 2019
- ↑ Anne Elizabeth Laumann. Which histologic findings are characteristic of trichilemmal cyst (pilar cyst)?. Medscape. Updated: Jun 11, 2020,
- ↑ Punnya V Angadi (2009-06-01). Skin: Pilomatricoma. Atlas of Genetics and Cytogenetics in Oncology and Haematology.
Image sources
- ↑ 1.0 1.1 Image(s) by: Mikael Häggström, M.D. Public Domain
- Author info
- Reusing images