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Pathology of Hidrocystoma-(Apocrine and Eccrine)

Dr Sampurna Roy MD            


Path Quiz Case 25: Case History and images:

Diagnosis: Apocrine hidrocystoma/Cystadenoma





Adenomatous cystic proliferation of apocrine glands. Some regard them as retension cysts, others regard some of these lesions with epithelial proliferation as benign tumours - Apocrine Cystadenoma.

Clinical presentation:  These may present as  uni or multilocular cystic structures containing clear or brownish fluid. 

It is suggested that the pigmentation observed clinically is due to the Tyndall phenomenon.

Site:  Located on the head and neck of older patients. Other sites include trunk and genital region.

Microscopic features: 

Cysts are lined by two layers of cells. The inner layer consists of tall columnar cells with eosinophilic cytoplasm and showing decapitation secretion.

The outer layer consists of myoepithelial cells. The apocrine cells probably contain lipofuscin granules.

These granules are PAS positive and diastase resistant.

Rarely, the lining epithelium shows papillary proliferation - Papillary apocrine gland cyst. 

(Differential Diagnosis : Hidradenoma papilliferum or  syringocystadenoma papilliferum.)

Immunohistochemistry:   Gross cystic disease fluid protein has been identified.


Apocrine hidrocystomas grow gradually and usually do not recur after excision.


Further reading

Apocrine Hidrocystoma of the Lower Lip: A Case Report and Literature Review.

Multiple apocrine hidrocystomas: a case report.

Multiple apocrine hidrocystomas: a case report.

Apocrine hidrocystoma of the cheek.

Apocrine hidrocystoma of the conjunctiva.

Multiple apocrine hidrocystomas of the eyelids.

Apocrine hidrocystoma masquerading as a posttraumatic cerebrospinal fluid leak: case report and literature review.

A brief report of a rare case of giant apocrine hidrocystoma presenting as a scalp hematoma.

External auditory canal apocrine hidrocystoma.

Apocrine secretion in lacrimal gland cysts (dacryops): a common but underrecognized phenomenon

Eccrine Hidrocystoma/Cystadenoma:

These are small ductal cysts lined by simple epithelium, usually found in adults.

Site: Usually located on the head, neck, trunk and chest.

Microscopic features: Cysts are lined by single layer of cuboidal cells. The myoepithelial cell layer is absent.

No decapitation secretion or PAS- positive cytoplasmic granules are present.

Cytokeratin 7, 8 and 19 are expressed in some cases.


Further reading:

Eccrine hidrocystoma: a neoformation to be considered in differential diagnoses of facial swellings

Giant eccrine hidrocystoma presenting with unilateral ptosis and epiphora.

Ultrasound biomicroscopy of eyelid eccrine hidrocystoma.

Multiple eccrine hidrocystomas.

Multiple eccrine hidrocystomas associated with Graves' disease.

Squamous cell carcinoma arising in an eccrine hidrocystoma. 

Eccrine hidrocystoma.

Eccrine hidrocystoma of the external ear canal: a case report.



Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)






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