Skin nonmelanocytic tumor

Cysts

Other cysts



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Last staff update: 20 April 2022

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PubMed Search: Cysts[TI] skin[TI]

See Also: Digital myxoid cyst, Idiopathic cystic chondromalacia of auricular cartilage, Median raphe cyst, Omphalomesentic duct cyst, Thymic cyst, Thyroglossal duct cyst

Ghassan A. Tranesh, M.D.
Hong Qu, M.D.
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Cite this page: Tranesh GA, Qu H. Other cysts. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skintumornonmelanocyticcystadenoma.html. Accessed January 29th, 2023.
Definition / general
Bronchogenic cyst
  • Bronchogenic cysts presenting in the skin are very rare, with fewer than 70 cases reported

Cutaneous ciliated cyst
  • Also called cystadenoma, cutaneous Müllerian cyst
  • Usually extremities of teenage girls
  • May have Müllerian derivation in females, distinct fetal eccrine duct origin in males
Epidemiology
Cutaneous ciliated cyst
  • Solitary lesion which presents shortly after menarche on limb of young females (12 - 42 years)
  • Also described in males and at atypical sites including back, shoulder, scalp, cheek
Sites
Bronchogenic cyst
  • Most are present at birth on the precordium or overlying the suprasternal notch
  • Occasionally occur near shoulder, back, scapula, neck, abdomen or chin or present at a later age

Cutaneous ciliated cyst
  • Thigh > buttock > calf > foot
Pathophysiology
Bronchogenic cyst
  • Believed to form from buds or diverticula that separate from foregut during development of the tracheobronchial tree
  • May be intrapulmonary or peripheral
  • Cutaneous bronchogenic cysts may result from subsequent sequestration outside the chest cavity following fusion of the mesenchymal bars of the sternum or from active migration prior to fusion

Cutaneous ciliated cyst
  • Lesions on limbs of young females are generally thought to be of Müllerian (paramesonephric) derivation, representing a migration abnormality of fetal development (heterotopia)
  • Cysts arising at other sites and in males may represent metaplasia of lining of a pre-existent simple cyst of sweat duct derivation or have an entirely different histogenesis
Clinical features
Bronchogenic cyst
  • 80% males
  • Variable presentation as cutaneous cystic nodule, sinus or papillomatous growth
  • Usually asymptomatic but may be tender or painful
  • Rarely are multiple
  • Treatment is surgical resection, if clinically indicated

Cutaneous ciliated cyst
  • Located in deep dermis or subcutaneous tissue
  • Usually asymptomatic
Case reports
Bronchogenic cyst
Cutaneous ciliated cyst
Treatment
Cutaneous ciliated cyst
  • Surgical excision
Clinical images

Images hosted on other servers:

Bronchogenic cyst
Sinus in suprasternal notch

Sinus in suprasternal notch

Sinus opening

Sinus opening

Gross description
Bronchogenic cyst
  • Skin nodule

Cutaneous ciliated cyst
  • Soft to cystic, solitary, movable, nontender, fluctuant swelling
Gross images

Images hosted on other servers:

Bronchogenic cyst
Scapular bronchogenic cyst

Scapular bronchogenic cyst


Cutaneous ciliated cyst
Round cyst with blue hue

Round cyst with blue hue

Microscopic (histologic) description
Bronchogenic cyst
  • Cutaneous bronchogenic cyst occurs within dermis or subcutaneous tissue
  • Lining is usually thrown into small folds
  • Epithelium is invariably ciliated, pseudostratified cuboidal or columnar, with mucus secreting goblet cells in 50% of cases
  • May have nonciliated cuboidal, columnar and stratified squamous epithelium
  • Smooth muscle supports the mucosa in 8% of cases
  • Lymphoid follicles are found in 25% of cases and appear to be part of a secondary inflammatory response
  • Occasionally seromucinous glands or cartilage are present
  • Cutaneous lung tissue heterotopia, in which fully developed bronchioles and alveoli are present, is considered a variant

Cutaneous ciliated cyst
  • Unilocular or multilocular cyst with intraluminal papillary projections of lining resembling fallopian tube
  • Cuboidal to columnar ciliated epithelium with frequent pseudostratified foci
  • Deep to the epithelium lie well vascularized parallel bundles of collagen but smooth muscle is not present
  • Occasional: squamous metaplasia, intercalated dark cells
  • Rare: mucin secreting cells, apocrine-like features
Microscopic (histologic) images

Images hosted on other servers:

Bronchogenic cyst
Pseudostratified ciliated columnar epithelium

Pseudostratified ciliated columnar epithelium

Ciliated respiratory epithelium

Ciliated respiratory epithelium

Respiratory and squamous epithelium

Respiratory and squamous epithelium



Cutaneous ciliated cyst
Epithelium-lined cyst in subcutaneous tissue

Epithelium lined cyst in subcutaneous tissue

Cilia on luminal border

Cilia on luminal border

Thin-walled cyst

Thin walled cyst

Focal squamous metaplasia

Focal squamous metaplasia

Cytokeratin+, EMA+

Cytokeratin+, EMA+


PanCK

PanCK

CEA-

CEA-

PR+, ER+

PR+, ER+

ER+

ER+

PR+

PR+

Cytology description
Bronchogenic cyst
Positive stains
Bronchogenic cyst
Cutaneous ciliated cyst
Electron microscopy description
Cutaneous ciliated cyst
  • Ultrastructurally, cilia have characteristic morphology with a central pair of microtubules, 9 radially orientated pairs of microtubules, basal bodies, cross striated rootlets
Differential diagnosis
Bronchogenic cyst
Cutaneous ciliated cyst
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