Hidrokistoma ve Kistadenom
Özet
Hidrokistoma ve kistadenom, ilk olarak 1893 yılında tanımlanmış, kökeni (retansiyon kisti veya neoplazm olması) uzun yıllardır tartışılan benign deri eki tümörleridir. Genellikle orta yaşlı ve yaşlı bireylerin yüz bölgesinde, özellikle periorbital alanda küçük, mavimsi nodüller veya kistik papüller olarak izlenirler. Lezyonlar yüksek sıcaklıklarda alevlenebilir ve nadiren Schöpf-Schulz-Passarge veya Goltz sendromları ile ilişkili olarak çok sayıda görülebilir. Histopatolojik incelemede, üstteki epidermis ile bağlantısı olmayan, içte kübik/kolumnar eozinofilik ve dışta miyoepitelyal hücrelerden oluşan çift tabakalı epitele sahip kistik yapılar dikkati çeker. Luminal yüzeyde apokrin çıkıntılar (snout) izlenebilir; ancak daha kompleks mikropapiller, papiller ve adenomatöz proliferasyonlar gösteren olgular kistadenom olarak adlandırılır. İmmunhistokimyasal olarak luminal hücrelerde EMA, CEA ve çeşitli sitokeratinler (CK7, CK18 vb.) eksprese edilirken, bazal hücreler S-100 ve alfa-düz kas aktini ile boyanır. Ayırıcı tanısında, lokalizasyon ve çevre doku özellikleri dikkate alınarak dacryops, median raphe kisti ve siringokistadenoma papilliferum gibi lezyonlar yer alır.
Hydrocystoma and cystadenoma are benign cutaneous adnexal tumors first defined in 1893, whose histogenesis—whether a retention cyst or a true neoplasm—has been debated for years. They typically present in middle-aged or elderly individuals as small, bluish nodules or cystic papules on the face, particularly in the periorbital region. These lesions can exacerbate in high temperatures and may rarely occur in large numbers associated with Schöpf-Schulz-Passarge or Goltz syndromes. Histopathologically, they appear as unilocular or multilocular cysts with no epidermal connection, lined by a double-layered epithelium consisting of outer myoepithelial cells and inner cubic/columnar eosinophilic cells. Apocrine snouts are observed on the luminal surface; however, lesions with complex micropapillary, papillary, or adenomatous proliferations are designated as cystadenomas. Immunohistochemically, luminal cells express EMA, CEA, and various cytokeratins (such as CK7 and CK18), while basal cells stain positive for S-100 and alpha-smooth muscle actin. Their differential diagnosis includes conditions like dacryops, median raphe cysts, and syringocystadenoma papilliferum, distinguishing them through anatomical localization and surrounding tissue features.
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