Kikuchi Kentaro, Fukunaga Shuichi, Inoue Harumi, Miyazaki Yuji, Ide Fumio, Kusama Kaoru
Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado, Saitama, 350-0283, Japan,
Head Neck Pathol. 2014 Mar;8(1):117-21. doi: 10.1007/s12105-013-0451-2. Epub 2013 Jun 6.
The hidrocystomas (HCs) are cystic forms of sweat gland resulting from proliferation of the apocrine secretory coil or eccrine duct. Apocrine -HCs are cystic lesions that arise from the apocrine secretory coil, while eccrine -HCs represent retention cysts of the eccrine duct. The commonest site for such lesions is around the eye, and they may also occur on the ears, scalp, chest, shoulders, or feet. However, HCs of the perioral region are uncommon. The differential diagnosis with minor salivary gland cyst or cystic neoplasms often poses a problem in this site. Here we report a rare case of apocrine -HC of the right lower lip for which excisional biopsy of the lesion was performed. Histopathologically, the lesion was a unilocular cyst lined by a double-layered epithelium of the apocrine secretory type. Immunohistochemically, the secretory epithelium was positive for mammaglobin, gross cystic disease fluid protein 15 (GCDFP-15), cytokeratin 7 (CK 7) and CK18, and the myoepithelium was positive for alpha-smooth muscle actin (α-SMA) and weakly positive for S100 protein. Here we present this very rare case of apocrine -HC of the lower lip, and discussed regarding differential diagnosis with minor salivary gland cystic lesion in the lip.
汗腺囊瘤(HCs)是由顶泌汗腺分泌蟠管或小汗腺导管增生导致的汗腺囊性病变。顶泌汗腺型HCs是起源于顶泌汗腺分泌蟠管的囊性病变,而小汗腺型HCs是小汗腺导管的潴留性囊肿。此类病变最常见于眼部周围,也可发生于耳部、头皮、胸部、肩部或足部。然而,口周区域的HCs并不常见。在此部位,与小涎腺囊肿或囊性肿瘤的鉴别诊断常常是个难题。本文报告1例右下唇顶泌汗腺型HCs的罕见病例,并对该病变进行了切除活检。组织病理学检查显示,病变为单房囊肿,内衬顶泌汗腺分泌型双层上皮。免疫组织化学检查显示,分泌上皮对乳腺珠蛋白、巨大囊肿病液体蛋白15(GCDFP-15)、细胞角蛋白7(CK 7)和CK18呈阳性反应,肌上皮对α-平滑肌肌动蛋白(α-SMA)呈阳性反应,对S100蛋白呈弱阳性反应。本文报道了这例非常罕见的下唇顶泌汗腺型HCs病例,并讨论了其与唇部小涎腺囊性病变的鉴别诊断。