1/9. Benign mucinous metaplasia of the penis. A lesion resembling extramammary Paget's disease.Benign mucinous metaplasia in the surface epithelium of the genital area is rare and has only been reported once in the vulva. A unique case of benign mucinous metaplasia of the prepuce in a 65-year-old man is reported here. The lesion measured 0.6 cm, was located in the mucous surface of the foreskin, and showed acid mucin containing cells. We regard benign mucinous metaplasia as a reactive rather than a neoplastic process. The main lesions to be considered in the differential diagnosis are mucinous syringometaplasia, extramammary Paget's disease, cutaneous squamous cell carcinoma in situ with mucinous metaplasia, superficial spreading malignant melanoma, and epidermotropic metastasis. The confinement of mucin-containing cells to the epidermis, the absence of nuclear atypia, the basal orientation of the nuclei, the predominant location of the cells in the upper layers of the epithelium, and the fact that the mucinous cells are replacing the squamous epithelium rather that infiltrating it, all assist in recognizing mucinous metaplasia of the penis as a specific and benign entity.- - - - - - - - - - ranking = 1keywords = epidermis (Clic here for more details about this article) |
2/9. Squamous metaplasia of Paget's disease.A patient had triple extramammary Paget's disease of both axillary and genital regions. Right inguinal lymphadenopathy was found 1 year after excision of all the skin lesions. Excisional biopsy of the lymph node demonstrated a mixture of Paget cells and atypical squamoid cells with horn pearls suggestive of keratinization. The squamoid cells were positive for cytokeratin 10, a marker of suprabasal epidermis, and also positive for laminin gamma2 which is often expressed in invasive squamous cell carcinoma. The coexistence of these different cells within the same tumour island suggested that the squamoid cells derived from metaplasia of Paget cells.- - - - - - - - - - ranking = 1keywords = epidermis (Clic here for more details about this article) |
3/9. Human papillomavirus-associated plantar epidermoid cyst related to epidermoid metaplasia of the eccrine duct epithelium: a combined histological, immunohistochemical, dna-dna in situ hybridization and three-dimensional reconstruction analysis.BACKGROUND: We recently proposed that certain palmoplantar epidermoid cysts may be related to eccrine ducts and that human papillomavirus (HPV) 60 may play a role in their pathomechanism. However, the origin of palmoplantar epidermoid cysts is still controversial. OBJECTIVES: To examine the contribution of eccrine ducts and HPV 60 in the development of epidermoid cysts. methods: Five epidermoid cysts and four ridged warts that had developed on the soles of a patient were studied histologically, immunohistochemically and by dna-dna in situ hybridization. Using serial sections obtained from its entire body, a three-dimensional reconstruction (3DR) analysis was performed on the smallest cyst to analyse the relationship between the epidermoid cyst, eccrine duct and the overlying epidermis. RESULTS: Histological and dna-dna in situ hybridization analyses demonstrated both homogeneous intracytoplasmic inclusion bodies pathognomonic for HPV 60 infection and HPV 60 dna sequences not only in all of the epidermoid cysts and ridged warts but also in the acrosyringeal portion of an eccrine duct, with the dermal portion of which the smallest cyst had been revealed to connect by 3DR analysis. However, immunohistochemical analyses using antibodies against human carcinoembryonic antigen (CEA), involucrin and several cytokeratins (CKs) revealed that the immunoreactivity of the cyst was not identical to that of the eccrine dermal duct but was identical to that of suprabasal layers of the epidermis. CONCLUSIONS: It was clearly demonstrated that an HPV 60-associated epidermoid cyst with immunoreactivities for CEA, involucrin and CKs which were identical to those of the epidermis connected with the eccrine dermal duct, supporting the idea that certain palmoplantar epidermoid cysts may develop following the epidermoid metaplasia of eccrine ducts with HPV 60 infection.- - - - - - - - - - ranking = 3keywords = epidermis (Clic here for more details about this article) |
4/9. Mucinous syringometaplasia with prominent epithelial hyperplasia and deep dermal involvement.This report describes two patients with mucinous syringometaplasia whose findings expand the microscopic and clinical spectrum of the entity. The first patient had an eroded nodule that exhibited multiple epidermal invaginations that penetrated deeply into the dermis. In addition to mucinous metaplasia, there was also exuberant papillary epithelial hyperplasia. Expanded eccrine ducts with similar changes appeared as lobules isolated in the dermis but were shown to connect with the invaginations. In the second patient, a clinical "cyst" drained serous fluid. Multiple papillary-cystic epithelial lobules similar to those seen in the first case were located in the dermis. A few approached the epidermis, but epidermal connections were not identified. The epithelium in these lesions was identical to that previously described in mucinous syringometaplasia. The tumors differed from prior cases by virtue of the number of eccrine apparatus involved, the extent and depth of involvement, and the presence of prominent papillary epithelial hyperplasia.- - - - - - - - - - ranking = 1keywords = epidermis (Clic here for more details about this article) |
5/9. Acral mucinous syringometaplasia. A benign cutaneous lesion associated with verrucous hyperplasia.We describe herein a case of acral mucinous syringometaplasia that presented clinically as a verruca plantaris. Microscopically, verrucous hyperplasia of the epidermis and central, dilated eccrine ducts lined by a mixture of squamous and goblet cells were present. Mucinous syringometaplasia is a benign entity that should be distinguished from other mucin-containing cutaneous lesions.- - - - - - - - - - ranking = 1keywords = epidermis (Clic here for more details about this article) |
6/9. Mucinous syringometaplasia.This is a clinicopathologic study of six patients with mucinous syringometaplasia, which was diagnosed histologically. Biopsies revealed a focal invagination of the epidermis lined by squamous epithelium, with one or several eccrine ducts leading into the vagination. The eccrine duct epithelium contained mucin-laden goblet cells, and there was mucinous syringometaplasia of the underlying eccrine coils. This histopathologic change was associated with two types of clinical lesions: (1) verrucous lesions, consistent with those described by previous authors, and (2) lesions suggestive of basal cell carcinoma, which have not been described with this pathologic entity in previous publications.- - - - - - - - - - ranking = 1keywords = epidermis (Clic here for more details about this article) |
7/9. Paget's disease in a squamous metaplasia of the urinary bladder. The first published case of a disease which is usually found in the epidermis.Extramammary Paget's disease is usually found in epidermis and is often associated with malignancy in visceral organs. We report the first case with Paget's disease developed in metaplastic squamous epithelium in the urinary bladder.- - - - - - - - - - ranking = 5keywords = epidermis (Clic here for more details about this article) |
8/9. Mucinous syringometaplasia. An immunohistochemical and ultrastructural study of a case.Mucinous syringometaplasia (MS) is an unusual skin lesion of unknown etiology, characterized histologically by epidermal invaginations lined by mucin-laden goblet-like cells and by nonkeratinized squamous cells. The present case study was performed to elucidate further the characteristics of this lesion using immunohistochemistry and electron microscopy. The mucin-laden cells in the MS lesion stained positively for carcinoembryonic antigen, epithelial membrane antigen, and low molecular weight keratins. The ultrastructural examination, which was performed on deparaffined sections, revealed two morphological variants of mucous granules. Electron-dense mucous granules predominated in the mucus-containing cells, which were situated among the keratinocytes adjacent to the epidermal invaginations, mostly in the lower parts of the epidermis. Larger, electron-lucent granules containing flocculent material were found more abundantly in the cells lining the epidermal invaginations. Also, some of the mucus-containing cells showed bundles of tonofilaments; structures that appeared to be isolated short, stubby microvilli; and attachments to adjacent mucus-containing cells and keratinocytes by desmosomes. The ultrastructural and immunohistochemical findings in our case suggest that the mucinous changes occurred as a metaplastic process in the resident epidermal cells and were accompanied by changes in cellular antigen expression resembling those of simple secretory epithelium.- - - - - - - - - - ranking = 1keywords = epidermis (Clic here for more details about this article) |
9/9. Eccrine squamous syringometaplasia in the skin of children after burns.We report 3 cases of severe burns in children in which eccrine squamous syringometaplasia (ESS) was found in skin biopsies taken 10 days after the trauma occurred. Microscopic examination showed partial or total necrosis of the epidermis, focal dermal necrosis and squamous metaplasia in eccrine ducts. These cases appear to be the first reported instances of ESS as an early consequence of severe burns.- - - - - - - - - - ranking = 1keywords = epidermis (Clic here for more details about this article) |