Cysts – Cutaneous Columnar Cysts

December 19th, 2010

Cutaneous Columnar Cysts are rather rare but I do occasionally encounter them in my The Woodlands dermatology and Conroe dermatology offices.  There are 5 types of Cutaneous Columnar Cysts:  1.Bronchogenic Cysts 2. Branchial Cleft Cysts 3. Thyroglossal Duct Cysts 4.Cutaneous Ciliated Cysts 5. Median Raphe Cysts.  Bronchogenic Cysts are found almost exclusively over the suprasternal notch or over the manubrium sterni, however they have been know to occur in other disparate areas such as the shoulder and abdomen.  Males are predominantly affected by Bronchogenic Cysts and they resemble normal Epithelial Inclusion Cysts clinically, but histologically they are lined by respiratory epithelium.  Bronchogenic Cysts are most often located in the subcutaneous tissue and have no underlying connections to deeper structures.  Branchial Cleft Cysts are typically found along the anterior border of the sternocleidomastoid muscle and the angle of the mandible.  Branchial Cleft Cysts are lined by stratified squamous epithelium and may clinically appear as a skin tag, cyst or sinus.  Thyroglossal Duct Cysts are consistently found on the anterior portion of the neck near the hyoid bone.  Thyroglossal Duct Cysts present as a cyst, abscess, or sinus and are the most common cause of childhood congenital neck anomalies, but they can present in adulthood.  Thyroglossal Duct Cysts are usually found deep in the subcutaneous tissue and 1% can give rise to malignancy.  Cutaneous Ciliated Cysts are usually found as solitary cysts on the legs of females.  Cutaneous Ciliated Cysts are lined by pseudostratified cuboidal or columnar epithelium with cilia.  Median Raphe Cysts are found on the penis and are caused by a developmental defect.  They may arise spontaneously after intercourse related trauma.  Median Raphe Cysts are lined by pseudostratified epithelium that may have cilia.  Occasionally, Median Raphe Cysts have pigment due to melanocytes being present in the cyst wall.  All 5 of the Cutaneous Columnar Cysts can be treated by surgical excision.

Bronchogenic Cyst- Histology Median Raphe Cyst