bromochloroacetic-acid and Follicular-Cyst

Currently it is well established that each of the three parts of the hair follicle (infundibulum, isthmus, and the inferior portion) originates different types of cutaneous cysts. Thus, follicular cysts include infundibular, trichilemmal, and matricial cysts. Brownstein in 1983 described a mixed type of cutaneous cyst combining epidermoid, infundibular, and trichilemmal types of keratinization. We review and illustrate the different combinations of follicular hybrid cysts reported to date: infundibular and trichilemmal cyst, infundibular and pilomatricoma cyst, trichilemmal and pilomatricoma cyst, eruptive vellus hair cyst and steatocystoma, and eruptive vellus hair cyst and trichilemmal cyst. Therefore, the concept of hybrid cyst should not be restricted to those composed of infundibular and trichilemmal cysts, because any cyst arising from the various parts of the pilosebaceous unit can combine with others to form a large series of follicular hybrid cysts.

Topics: Diagnosis, Differential; Follicular Cyst; Hair; Hair Diseases; Humans; Keratins; Skin Diseases

Trichoblastic infundibular cyst (TBIC) was previously reported as a unique keratinous cystic lesion, which was characterized by the papillary projections of follicular germinative-like cells emanating from the cyst wall. Here, we report three additional cases of this cyst and discuss the pathogenesis of this unique entity. In all cases, a unilocular cyst contained keratin, and the cyst wall was composed of squamous epithelium. A number of cords and papillary projections emanated from the basal layer of the cyst wall. They were composed of cells with large nuclei and scant cytoplasm arranged in a peripheral palisade. Immunohistochemically, anti-cytokeratin 15, anti-cytokeratin 20, and anti-epithelial cell adhesion molecule antibodies were negative. Thus, these cells resembled follicular germinative cells or sebaceous mantle morphologically, but we failed to prove the differentiation immunohistochemically. The cyst was surrounded by fibrotic stroma and inflammatory cells, suggesting previous rupture of the cyst. We speculate that the cells of the projections possibly differentiate into the mantle rather than follicular germinative cells, even though we could not provide sufficient immunohistochemical evidence. We also suggest that they may be induced by special reaction to fibrohistiocytic stroma surrounding the infundibular cyst. Therefore, TBIC should be renamed infundibular cyst with unique papillary projections.

Topics: Adult; Aged; Asian People; Diagnosis, Differential; Epidermal Cyst; Follicular Cyst; Hair Follicle; Humans; Immunohistochemistry; Keratins; Male; Margins of Excision; Middle Aged; Skin Neoplasms

We herein report two cases of cystic trichoblastoma with an immunohistochemical study. The histopathological findings in these cases included new information, namely, their being composed of two and three cysts, the cystic components had features of a steatocystoma and a hybrid cyst in one case, and there were projections of an aggregation of trichoblastoma, as well as papillary projections of follicular germinative cells, from the cyst walls. The follicular germinative cells observed in the papillary projections and in the aggregations of trichoblastoma expressed cytokeratin-15 (clone C8/144B) and PHLDA1, markers of follicular stem cells. Cystic trichoblastoma is a unique type of trichoblastoma, which originates from the cyst walls of an infundibular cyst (usually) or steatocystoma/hybrid cyst (rarely). In some cases, a trichoblastic infundibular cyst is considered to be a minor form (or possibly a primitive stage) of cystic trichoblastoma.

Topics: Aged; Aged, 80 and over; Biomarkers, Tumor; Female; Follicular Cyst; Hair Diseases; Humans; Immunohistochemistry; Keratins; Male; Skin Neoplasms; Transcription Factors

Topics: Aged; Cell Proliferation; Epidermal Cyst; Epithelial Cells; Female; Follicular Cyst; Hair Diseases; Humans; Keratins

The KAI-1 tumor suppressor gene is widely distributed in normal tissues and its down-regulation may be correlated with the invasive phenotype and metastases in several different epithelial tumors. The aim of the present study was an evaluation of KAI-1 expression in radicular cysts (RC), follicular cysts (FC), orthokeratinized keratocysts (OOKC), and parakeratinized keratocysts (POKC). Eighty-five odontogenic cysts, 28 RC, 22 FC, and 35 OKC (16 OOKC, 19 POKC) were selected. All the POKC were negative and only four of 16 of the OOKC were positive for KAI-1. On the contrary, all RC and FC cases were positive and immunoreactivity for KAI-1 was detected throughout all the layers of the cyst epithelium. The lack of KAI-1 expression in POKC could help to explain the differences in the clinical and pathologic behavior of OKC and, according to what has been reported for epithelial tumors, could be related to the increased aggressive behavior and invasiveness of OKC.

Topics: Follicular Cyst; Gene Expression; Humans; Immunohistochemistry; Jaw Cysts; Kangai-1 Protein; Keratins; Odontogenic Cysts; Odontogenic Tumors

Topics: Anus Diseases; Diagnosis, Differential; Epidermal Cyst; Follicular Cyst; Hair Follicle; Humans; Keratins; Male; Middle Aged; Nevus, Pigmented

Panfolliculoma is a rare follicular neoplasm with differentiation toward both upper (infundibulum and isthmus) and lower (stem, hair matrix, and bulb) segments of a hair follicle. We present an unusual case of cystic panfolliculoma. A 33-year-old Hispanic woman presented with an 8-month history of a 3.0-cm cystic scalp mass. The lesion was excised, and the histologic sections showed a cystic follicular neoplasm that contained corneocytes in basket-woven and laminated array, trichohyalin granules of the inner root sheath, germinative cells, papillae, matrical cells, and "shadow" cells. Cytokeratin 903 and cytokeratin 5/6 immunostains uniformly highlight the tumor cells. Ber-EP4 strongly labels the germinative cells but not the follicular papillae. CD34 labels the surrounding fibrotic stroma and focally the epithelial component.

Topics: Adult; Biomarkers, Tumor; Epidermal Cyst; Female; Follicular Cyst; Hair Follicle; Humans; Keratins; Neoplasms, Basal Cell; Skin; Skin Neoplasms

Within stratified squamous epithelia, such as the epidermis, desmogleins are generally expressed in a differentiation-specific manner. Similar to the epidermis, the hair follicle is compartmentalized into a hierarchy of cell types based on their level of differentiation. Relatively undifferentiated stem cells in the bulge can generate epidermis, sebaceous gland, and hair bulb matrix cells. The latter give rise to at least six different cell types that keratinize as they move up the hair shaft and inner root sheath. Here, we examined expression patterns of the desmoglein isotypes, desmogleins 1, 2, and 3 in the cutaneous epithelium, and discovered that desmoglein 1 and 2 expression correlated with the state of differentiation of defined populations within the hair follicle. Desmoglein 2 was highly expressed by the least differentiated cells of the cutaneous epithelium, including the hair follicle bulge of the fetus and adult, bulb matrix cells, and basal layer of the outer root sheath. In contrast, desmoglein 1 defined more differentiated cell populations, and was expressed in epidermal suprabasal cells, the inner root sheath, and the innermost layers of the outer root sheath. We found that the expression pattern of desmoglein 3 correlated with different types of keratinization. In areas of trichilemmal keratinization in the follicle, and in cysts arising from these areas, desmoglein 3 was expressed throughout all layers of the outer root sheath and cyst wall. In areas of epidermal-like keratinization, such as in the infundibulum and in epidermal inclusion cysts, desmoglein 3 expression was limited mainly to the basal layer. We conclude that desmoglein expression patterns define compartments of cells in similar states of differentiation within the cutaneous epithelium, and reveal a hierarchy of differentiation among these compartments.

Topics: Adult; Cadherins; Cell Differentiation; Cytoskeletal Proteins; Desmoglein 1; Desmoglein 2; Desmoglein 3; Desmogleins; Desmoplakins; Fetus; Follicular Cyst; Hair Diseases; Hair Follicle; Humans; Keratins

An otherwise healthy 24-year-old woman presented with persistent asymptomatic skin-coloured papular lesions on her trunk which had appeared over 18 months, gradually increasing in number, size and the extent of the skin surface area involved. Physical examination revealed multiple flesh - to whitish - coloured papules, 2 to 5 mm in diameter, located on her neck, anterior chest wall, axillae and upper abdomen (Fig. 1). The lesions were smooth, painless on palpation and not grouped. Laboratory investigations only showed normal results. Histopathological examination of a papular lesion from the upper abdomen revealed a cystic structure in the mid-dermis lined by four to five layers of squamous epithelium with a discrete granular layer. Laminated keratinous material and multiple transversely or obliquely cut vellus hairs were present within the cyst, while sebaceous elements were lacking in the vicinity or within the cyst wall (Fig. 2a, b). Polaroscopic examination demonstrated double refractile vellus hairs in the cyst.

Topics: Adult; Diagnosis, Differential; Female; Follicular Cyst; Hair Diseases; Humans; Keratins

Lectin-binding patterns were examined in epithelial walls of 65 jaw cysts (30 post-operative maxillary cysts: POMCs, 20 radicular and 15 follicular cysts), and characteristic lectin staining for each kind of jaw cysts is presented. Between squamous and columnar epithelia, the staining intensity of WGA, Con A and UEA-I was not different, but SBA bound more remarkably to squamous than to columnar epithelia. In both epithelia the outer layers did react more strongly with the lectins examined. Concerning odontogenic cysts, the lectin-binding affinities of outer and intermediate layer cells were nearly the same in both follicular and radicular cysts. Basal cells of radicular cyst walls were however, more markedly positive for lectin binding than of follicular cysts. Furthermore, basal cells of keratinized (RKSE 60 keratin-positive) epithelium were inferior to those of non-keratinized linings in the bindings. Lectin-binding patterns of metaplastic squamose epithelia of POMCs which were positive for RGE53-keratin (principally columnar epithelium-specific keratin) were similar to originally squamous linings of odontogenic cysts. Columnar linings of unusual radicular cysts were positively stained with SBA. By these results, lectin-binding sugar residues of the epithelium seem to be related to the epithelial morphology.

Topics: Antibodies; Epithelium; Follicular Cyst; Histocytochemistry; Humans; Jaw Cysts; Keratins; Lectins; Staining and Labeling

Immunostaining with monoclonal antibodies was used to study and compare the cytokeratin content of odontogenic cysts and normal gingival epithelium. Two monoclonal antibodies, PKK2 and KA1, stained the whole epithelium in all cyst samples. In gingiva, PKK2 gave a suprabasal staining and KA1 reacted with all epithelial cell layers. Antibodies PKK1, KM 4.62 and KS 8.12 gave a heterogeneous staining in follicular and radicular cysts. In keratocysts and in gingiva PKK1 and KM 4.62 reacted mainly with basal cells and KS 8.12 gave a suprabasal staining. Antibodies reacting with the simple epithelial cytokeratin polypeptide No. 18 (PKK3, KS 18.18) recognized in gingiva only solitary cells compatible with Merkel cells. In a case of follicular ameloblastoma a distinct staining of tumor epithelium was revealed with these antibodies. In 2 follicular cysts, but not in other cyst types, a layer of cytokeratin 18-positive cells was revealed. KA5 and KK 8.60 antibodies, reacting exclusively with keratinizing epithelia, including normal gingiva, gave no reaction in radicular cysts, keratocysts and ameloblastoma. Two of the follicular cysts, were negative for PKK3 and KS 18.18, but reacted strongly with KA5 and KK 8.60. The present results show that odontogenic jaw cysts have distinct differences in their cytokeratin content. With the exception of some follicular cysts, they lack signs of keratinizing epithelial differentiation. Only follicular cysts appear to share with some types of ameloblastoma the expression of cytokeratin polypeptide No. 18.

Topics: Ameloblastoma; Antibodies, Monoclonal; Epithelium; Follicular Cyst; Gingiva; Humans; Jaw Diseases; Jaw Neoplasms; Keratins; Microscopy, Fluorescence; Odontogenic Cysts; Radicular Cyst