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Difference between revisions of "Pilar cyst"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Trichilemmal_cyst_-_very_high_mag.jpg | |||
| Width = | |||
| Caption = Pilar cyst. [[H&E stain]]. | |||
| Micro = cyst lining by a stratified squamous epithelium without a granular layer - contains keratin; no significant nuclear atypia; +/-[[granuloma|granulomatous inflammation]] (due to rupture) | |||
| Subtypes = | |||
| LMDDx = [[epidermal inclusion cyst]] | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = nodule +/-yellow colour | |||
| Grossing = | |||
| Site = [[skin]] - usu. scalp | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = very common | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = benign | |||
| Other = | |||
| ClinDDx = other [[skin cysts]] | |||
}} | |||
'''Pilar cyst''', also known as a '''trichilemmal cyst''', is a common benign [[dermal cysts|skin cyst]]. | |||
==General== | |||
*Very common. | |||
*Benign.‡ | |||
*The clinical history for these typically says ''[[sebaceous cyst]]''. | |||
Note: | |||
*‡A super rare malignant counter part is described; approximately 40 cases are reported in the english literature.<ref name=pmid22470211>{{Cite journal | last1 = Goyal | first1 = S. | last2 = Jain | first2 = BB. | last3 = Jana | first3 = S. | last4 = Bhattacharya | first4 = SK. | title = Malignant proliferating trichilemmal tumor. | journal = Indian J Dermatol | volume = 57 | issue = 1 | pages = 50-2 | month = Jan | year = 2012 | doi = 10.4103/0019-5154.92679 | PMID = 22470211 }}</ref> | |||
==Gross== | |||
*Classic location: head ~90%.<ref>URL: [http://emedicine.medscape.com/article/1058907-overview http://emedicine.medscape.com/article/1058907-overview]. Accessed on: 15 April 2012.</ref> | |||
==Microscopic== | |||
Features:<ref name=Ref_Derm309>{{Ref Derm|309}}</ref> | |||
*Keratin. | |||
*Cyst lining: | |||
**Has no granular layer - '''key feature'''. | |||
***Keratohyaline granules (as seen in the granular layer) may be seen focally. | |||
**Inner most cyst lining cells are large cells with abundant eosinophilic cytoplasm. | |||
DDx: | |||
*[[Epidermal cyst]] - has a granular layer. | |||
*[[Squamous cell carcinoma of the skin|Squamous cell carcinoma]] arising from a pilar cyst. | |||
===Images=== | |||
<gallery> | |||
Image:Trichilemmal_cyst_-_intermed_mag.jpg | Trichilemmal cyst - intermed. mag. (WC) | |||
Image:Trichilemmal_cyst_-_high_mag.jpg | Trichilemmal cyst - high mag. (WC) | |||
Image:Trichilemmal_cyst_-_very_high_mag.jpg | Trichilemmal cyst - very high mag. (WC) | |||
</gallery> | |||
www: | |||
*[http://dermatlas.med.jhmi.edu/derm/indexDisplay.cfm?ImageID=69966366 Trichilemmal cyst (dermatlas.med.jhmi.edu)]. | |||
*[http://www.flickr.com/photos/40764007@N08/3881846034/in/photostream/ Trichilemmal cyst (flickr.com)]. | |||
==Sign out== | |||
<pre> | |||
Scalp (Cyst), Excision: | |||
- Benign trichilemmal cyst (pilar cyst). | |||
</pre> | |||
===Block letters=== | |||
<pre> | |||
SCALP (CYST), EXCISION: | |||
- TRICHILEMMAL CYST (PILAR CYST). | |||
</pre> | |||
<pre> | |||
SKIN CYST, LEFT FLANK, EXCISION: | |||
- TRICHILEMMAL CYST (PILAR CYST). | |||
</pre> | |||
<pre> | |||
SCALP (CYST), ANTERIOR, EXCISION: | |||
- TRICHILEMMAL CYST (PILAR CYST), RUPTURED. | |||
</pre> | |||
===Micro=== | |||
The sections show a cyst that is lined by squamous epithelium without a granular layer. Focally, keratohyaline granules are seen in the cyst lining cells. The innermost cyst lining cells are large and have abundant eosinophilic cytoplasm. The cyst contains keratin. | |||
==See also== | |||
*[[Dermal cysts]]. | |||
==References== | |||
{{Reflist|1}} | |||
[[Category:Diagnosis]] | |||
[[Category:Dermal cysts]] | |||