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Trichilemmal cysts with proteinaceous material: A potential diagnostic pitfall.
Yasuhiro Mitsui1, Kohei Ogawa1, Kaori Koga2
1Department of Dermatology, Nara Medical University School of Medicine, Kashihara, Japan.
Journal of Cutaneous Pathology
|February 15, 2022
Summary
Histopathology and immunohistochemistry aid in diagnosing trichilemmal cysts with proteinaceous material (TCPM). Specific markers like CD117, CK19, and CK10 help differentiate TCPMs from sweat gland tumors.
Area of Science:
- Dermatopathology
- Oncology
Background:
- Skin cysts are common, but atypical presentations can complicate diagnosis.
- Distinguishing trichilemmal cyst with proteinaceous material (TCPM) from sweat duct/gland tumors is clinically relevant.
Purpose of the Study:
- To investigate the histopathological features of TCPMs.
- To evaluate the utility of immunohistochemical markers in differentiating TCPMs from other cystic lesions.
Main Methods:
- Examined five cases of TCPM and compared them with trichilemmal cysts (TCs), clear-cell hidradenomas, poroid hidradenomas, and normal adnexa.
- Performed immunohistochemical analysis for cytokeratin (CK) 10, CK13, CK17, CK19, CD8, and CD117.
Main Results:
- TCPMs exhibited apoptotic cells in the cyst wall and keratin/calcification in the cavity.
- TCPMs and TCs were negative for CK19 and CD117, unlike clear-cell and poroid hidradenomas.
- CK10 showed restricted positivity in the suprabasal layers of TCPMs and TCs, similar to normal follicular isthmus.
Conclusions:
- Histopathological findings combined with immunohistochemistry for CD117, CK19, and CK10 are crucial for accurate TCPM diagnosis.
- Immunohistochemical profiles aid in differentiating TCPMs from sweat gland tumors.
