Department of Cleveland Clinic, Pathology and Dermatology Institute, Cleveland, OH.
Am J Dermatopathol. 2023 May 1;45(5):330-332. doi: 10.1097/DAD.0000000000002409. Epub 2023 Mar 20.
Mucinous metaplasia (goblet cell type) is exceptionally rare in the skin. This is the second case of apocrine papillary hidrocystoma with mucinous metaplasia (goblet cell type) and a review of the literature exploring the significance and frequency of mucinous metaplasia with goblet cells in nongenital skin. The patient is an elderly man who presented with a blue-pigmented nodule on the scalp that was clinically suggestive of an atypical nevus. Histologically, the lesion was composed of a simple cyst of cuboidal cells with decapitation secretion and mucinous metaplasia with goblet cells. Papillary formation was identified in the cysts. Most cases of cutaneous mucinous metaplasia have been reported on genital skin, usually after chronic inflammation of the area. This type of mucinous metaplasia is categorized as benign mucinous metaplasia of the genitalia (BMM) and is believed to be unrelated to apocrine glands owing to the different histologic features and absence of apocrine differentiation by immunohistochemistry. Mucinous metaplasia (goblet cell type) has been previously reported in benign adnexal tumors (eccrine acrospiroma/hidroadenoma, mixed tumor, and syringocystadenoma papilliferum) and in malignant tumors (apocrine hidradenocarcinoma and squamous cell carcinoma). To date, mucinous metaplasia has not been identified in the histologically normal apocrine glands.
黏液性化生（杯状细胞型）在皮肤中极为罕见。这是第二个具有黏液性化生（杯状细胞型）的大汗腺乳头状囊腺瘤的病例，并对文献进行了回顾，探讨了非生殖器皮肤中具有杯状细胞的黏液性化生的意义和频率。患者是一位老年男性，头皮上出现蓝染性结节，临床上提示为非典型痣。组织学上，病变由具有断头分泌的立方细胞组成的单纯囊肿和具有杯状细胞的黏液性化生构成。在囊肿中发现了乳头状形成。大多数皮肤黏液性化生的病例报告都发生在生殖器皮肤，通常是在该区域慢性炎症之后。这种类型的黏液性化生被归类为生殖器良性黏液性化生（BMM），由于组织学特征不同且免疫组织化学检查缺乏大汗腺分化，因此被认为与大汗腺无关。黏液性化生（杯状细胞型）以前曾在良性附属器肿瘤（大汗腺汗孔瘤/汗腺瘤、混合瘤和囊性腺瘤样乳头状瘤）和恶性肿瘤（大汗腺汗管癌和鳞状细胞癌）中报道过。迄今为止，在组织学正常的大汗腺中尚未发现黏液性化生。
