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Case Study: December 2016
History
A 55 year-old male present with a 2mm, smooth, brown pigmented nodule on the lower lid that has been present for 2 years. The lesion is excised and sent for histopathological examination.
Figure 1 shows a low power image.
Figure 2 shows a higher power of the lining of the lesion
Questions
1. What are the main features of the pathology seen in figures 1 and 2?
2. What is the pigment in figure 1?
3. What is the diagnosis?
4. Which syndromes are associated with this lesion?
Answers
1. This is a cyst lined by bilayered epithelium containing greyish pigment.
2. This could be lipofuscin, melanin, iron or drug pigment.
3. Ductal hidrocystoma / cyst of Moll. Whether these are eccrine or apocrine is a moot point.
4. Sydromes that are associated with multiple ductal hidrocystoma include Schopf-Schulz-Passarge, Goltz-Gorlin and Grave’s disease.
