Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas 77030, USA.
Arch Pathol Lab Med. 2013 Apr;137(4):576-9. doi: 10.5858/arpa.2011-0381-CR.
A 58-year-old woman presented with a cystic skin lesion. Microscopic examination showed an intradermal cyst lined by acanthotic squamous epithelium with squamous eddies and compact hyperkeratosis, and changes typical of verrucous lesions. Mature sebaceous cells and dendritic melanocytes were present as well. To our knowledge, this is the first report of a verrucous cyst with areas of sebaceous differentiation and melanocytes. Verrucous cysts are well-known, benign lesions with a clear histologic pattern. Histologically, they resemble verruca vulgaris with acanthosis, hypergranulosis, dense keratohyaline granules, and viral cytopathic effects seen. Until now, melanocytes and mature sebaceous cells in the cyst lining have not been reported. We do not feel that these findings alter the expected benign nature of this lesion. Instead, we report this case to suggest the possible adnexal embryonic origin, given the presence of sebaceous cells and dendritic melanocytes that support this histologic lineage in our specific case.
一位 58 岁女性出现了囊性皮肤病变。显微镜检查显示，真皮内的囊肿由棘层肥厚的鳞状上皮排列，伴鳞状漩涡和致密性角化过度，以及典型的疣状病变改变。同时存在成熟的皮脂腺细胞和树枝状黑素细胞。据我们所知，这是首例报道的具有皮脂腺分化和黑素细胞的疣状囊肿。疣状囊肿是一种众所周知的良性病变，具有明确的组织学模式。组织学上，它们类似于寻常疣，表现为棘层肥厚、过度角化、致密的角蛋白颗粒和可见的病毒细胞病变效应。到目前为止，囊壁中的黑素细胞和成熟的皮脂腺细胞尚未被报道。我们并不认为这些发现改变了该病变的预期良性性质。相反，我们报告这个病例是为了提示可能的附属胚胎起源，因为在我们的具体病例中存在支持这种组织学谱系的皮脂腺细胞和树枝状黑素细胞。
