Medscape is available in 5 Language Editions – Choose your Edition here.


Cutaneous Columnar Cysts Workup

  • Author: Niels Holm, MB, BCh; Chief Editor: William D James, MD  more...
Updated: Aug 11, 2014

Imaging Studies

Imaging should be performed on these cysts to exclude a deep connection; however, whether one imaging modality is superior to others is uncertain. Ultrasonography, CT scanning, or MRI may be helpful in locating thyroid tissue.

Perform thyroid function tests with radionucleotide scanning on thyroglossal cysts to assess the location and to determine the function of the thyroid. Perform these tests preoperatively because sometimes the ectopic thyroid is the only functioning thyroid tissue and removal of the ectopic thyroid causes hypothyroidism.


Histologic Findings

In thyroglossal cysts, tubular glands are lined by respiratory epithelium with columnar cells.

The wall of thymic cysts contains Hassall corpuscles; lymphoid tissue; and, occasionally, parathyroid tissue and cholesterol granulomas. Although the lining is often columnar, it may also be squamous, cuboidal, or pseudostratified columnar.

Bronchogenic cysts are lined by ciliated pseudostratified columnar or cuboidal epithelium that produces mucin. Smooth muscle and mucous glands are found in the wall. Cartilage is seldom observed. Some inflammation and fibrosis in the surrounding tissues are common.

Cutaneous ciliated cysts are lined by ciliated cuboidal or columnar pseudostratified epithelium. Papillary projections into the lumen and cysts may be multilocular. Mucinous cells are rare. No smooth muscle or glands can be demonstrated.

Median raphe cysts are located in the dermis and are lined by pseudostratified columnar epithelium. Mucous glands and cilia are occasionally found. Near the meatus, the lining changes to stratified squamous epithelium.

Contributor Information and Disclosures

Niels Holm, MB, BCh MMEd, FCDerm(SA), Dermatologist, Private Practice, Stellenbosch, South Africa

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Christen M Mowad, MD Professor, Department of Dermatology, Geisinger Medical Center

Christen M Mowad, MD is a member of the following medical societies: Alpha Omega Alpha, Noah Worcester Dermatological Society, Pennsylvania Academy of Dermatology, American Academy of Dermatology, Phi Beta Kappa

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Shyam Verma, MBBS, DVD, FAAD Clinical Associate Professor, Department of Dermatology, University of Virginia School of Medicine; Adjunct Associate Professor, Department of Dermatology, State University of New York at Stonybrook School of Medicine; Adjunct Associate Professor, Department of Dermatology, University of Pennsylvania School of Medicine

Shyam Verma, MBBS, DVD, FAAD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.


Walter HC Burgdorf, MD Clinical Lecturer, Department of Dermatology, Ludwig Maximilian University, Munich, Germany

Disclosure: Nothing to disclose

  1. Thompson LD. Branchial cleft cyst. Ear Nose Throat J. 2004 Nov. 83(11):740. [Medline].

  2. Brousseau VJ, Solares CA, Xu M, et al. Thyroglossal duct cysts: presentation and management in children versus adults. Int J Pediatr Otorhinolaryngol. 2003 Dec. 67(12):1285-90. [Medline].

  3. Bsoul SA, Flint DJ, Terezhalmy GT, Moore WS. Thyroglossal duct cyst. Quintessence Int. 2003 Feb. 34(2):156-7. [Medline].

  4. Chandran BS, Raman A, Perakath B, et al. Primary papillary carcinoma in a thyroglossal cyst. J Assoc Physicians India. 2001 Feb. 49:283. [Medline].

  5. Foley DS, Fallat ME. Thyroglossal duct and other congenital midline cervical anomalies. Semin Pediatr Surg. 2006 May. 15(2):70-5. [Medline].

  6. Berenos-Riley L, Manni JJ, Coronel C, De Wilde PC. Thymic cyst in the neck. Acta Otolaryngol. 2005 Jan. 125(1):108-12. [Medline].

  7. Al-kasspooles MF, Alberico RA, Douglas WG, et al. Bronchogenic cyst presenting as a symptomatic neck mass in an adult: case report and review of the literature. Laryngoscope. 2004 Dec. 114(12):2214-7. [Medline].

  8. Gaikwad P, Muthusami JC, Raj JP, et al. Subcutaneous bronchogenic cyst. Otolaryngol Head Neck Surg. 2006 Dec. 135(6):951-2. [Medline].

  9. Kim NR, Kim HH, Suh YL. Cutaneous bronchogenic cyst of the abdominal wall. Pathol Int. 2001. 51(12):970-3. [Medline].

  10. Miller OF 3rd, Tyler W. Cutaneous bronchogenic cyst with papilloma and sinus presentation. J Am Acad Dermatol. 1984 Aug. 11(2 Pt 2):367-71. [Medline].

  11. Newkirk KA, Tassler AB, Krowiak EJ, Deeb ZE. Bronchogenic cysts of the neck in adults. Ann Otol Rhinol Laryngol. 2004 Sep. 113(9):691-5. [Medline].

  12. Tresser NJ, Dahms B, Berner JJ. Cutaneous bronchogenic cyst of the back: a case report and review of the literature. Pediatr Pathol. 1994 Mar-Apr. 14(2):207-12. [Medline].

  13. Carden C, Dykes E, Pollock AM. An unusual midline swelling--case report of a cutaneous bronchogenic cyst. Eur J Pediatr Surg. 2008 Oct. 18(5):345-6. [Medline].

  14. Nakamura Y, Fujishima F, Ito S, Ishida K, Sato S, Watanabe M, et al. A case of cutaneous bronchogenic cyst in the scapular area. Pol J Pathol. 2011 Jun. 62(2):120-1. [Medline].

  15. Adim SB, Baskan EB, Saricaoglu H, Elezoglu B. Cutaneous heterotopic bronchogenic tissue in the scapular area. Australas J Dermatol. 2010 Feb. 51(1):42-4. [Medline].

  16. Acenero MJ, Garcia-Gonzalez J. Median raphe cyst with ciliated cells: report of a case. Am J Dermatopathol. 2003 Apr. 25(2):175-6. [Medline].

  17. Cardoso R, Freitas JD, Reis JP, Tellechea O. Median raphe cyst of the penis. Dermatol Online J. 2005. 11(3):37. [Medline].

  18. Park CO, Chun EY, Lee JH. Median raphe cyst on the scrotum and perineum. J Am Acad Dermatol. 2006 Nov. 55(5 Suppl):S114-5. [Medline].

  19. Romani J, Barnadas MA, Miralles J, et al. Median raphe cyst of the penis with ciliated cells. J Cutan Pathol. 1995 Aug. 22(4):378-81. [Medline].

  20. Sharkey MJ, Grabski WJ, McCollough ML, Berger TG. Postcoital appearance of a median raphe cyst. J Am Acad Dermatol. 1992 Feb. 26(2 Pt 1):273-4. [Medline].

  21. Shibagaki N, Ohtake N, Furue M. Spontaneous regression of congenital multiple median raphe cysts of the raphe scroti. Br J Dermatol. 1996 Feb. 134(2):376-8. [Medline].

  22. Urahashi J, Hara H, Yamaguchi Z, Morishima T. Pigmented median raphe cysts of the penis. Acta Derm Venereol. 2000 Jul-Aug. 80(4):297-8. [Medline].

  23. Amaranathan A, Sinhasan SP, Dasiah SD. Median raphe cysts of the prepucial skin, with triple histological linings: a case report and review of the literature. J Clin Diagn Res. 2013 Jul. 7(7):1466-8. [Medline]. [Full Text].

  24. Joehlin-Price AS, Huang JH, Brooks JS, Scharschmidt TJ, Iwenofu OH. PAX-8 expression in cutaneous ciliated cysts: evidence for Müllerian origin. Am J Dermatopathol. 2014 Feb. 36(2):167-70. [Medline].

  25. Cortes-Franco R, Carrasco D, Teixeira F, Dominguez-Soto L. Cutaneous ciliated cyst. Int J Dermatol. 1995 Jan. 34(1):32-3. [Medline].

  26. Dini M, Lo Russo G, Baroni G, Colafranceschi M. Cutaneous ciliated cyst: a case report with immunohistochemical evidence for dynein in ciliated cells. Am J Dermatopathol. 2000 Dec. 22(6):519-23. [Medline].

  27. Farmer ER, Helwig EB. Cutaneous ciliated cysts. Arch Dermatol. 1978 Jan. 114(1):70-3. [Medline].

  28. Fontaine DG, Lau H, Murray SK, et al. Cutaneous ciliated cyst of the abdominal wall: a case report with a review of the literature and discussion of pathogenesis. Am J Dermatopathol. 2002 Feb. 24(1):63-6. [Medline].

  29. Kang IK, Kim YJ, Choi KC. Ciliated cyst of the vulva. J Am Acad Dermatol. 1995 Mar. 32(3):514-5. [Medline].

  30. Sickel JZ. Cutaneous ciliated cyst of the scalp. A case report with immunohistochemical evidence for estrogen and progesterone receptors. Am J Dermatopathol. 1994 Feb. 16(1):76-9. [Medline].

  31. Trotter SE, Rassl DM, Saad M, et al. Cutaneous ciliated cyst occurring in a male. Histopathology. 1994 Nov. 25(5):492-3. [Medline].

  32. Vadmal MS, Makarewicz K, Fontaine DG, Wright JR Jr. Cutaneous ciliated cyst of the abdominal wall. Am J Dermatopathol. 2002 Oct. 24(5):452-3; author reply 453. [Medline].

  33. Yokozaki H, Yanagawa E, Harada M, Tahara E. Cutaneous ciliated cyst of the right lower leg. Pathol Int. 1999 Apr. 49(4):354-7. [Medline].

  34. Chong SJ, Kim SY, Kim HS, Kim GM, Kim SY, Jung JH. Cutaneous ciliated cyst in a 16-year-old girl. J Am Acad Dermatol. 2007 Jan. 56(1):159-60. [Medline].

  35. Gelincik I. Cutaneous ciliated cyst in the subcutaneous area. Indian J Pathol Microbiol. 2011 Jan-Mar. 54(1):150-1. [Medline].

  36. Pastore V, Bartoli F. "Extended" Sistrunk procedure in the treatment of recurrent thyroglossal duct cysts: A 10-year experience. Int J Pediatr Otorhinolaryngol. 2014 Sep. 78(9):1534-6. [Medline].

  37. Rohof D, Honings J, Theunisse HJ, Schutte HW, van den Hoogen FJ, van den Broek GB, et al. Recurrences after thyroglossal duct cyst surgery: Results in 207 consecutive cases and review of the literature. Head Neck. 2014 Jul 1. [Medline].

  38. Andrews PJ, Giddings CE, Su AP. Management of lateral cystic swellings of the neck, in the over 40s' age group. J Laryngol Otol. 2003 Apr. 117(4):318-20. [Medline].

  39. Claudy AL, Dutoit M, Boucheron S. Epidermal and urethroid penile cyst. Acta Derm Venereol. 1991. 71(1):61-2. [Medline].

  40. Drolet BA, Baselga E, Gosain AK, et al. Preauricular skin defects. A consequence of a persistent ectodermal groove. Arch Dermatol. 1997 Dec. 133(12):1551-4. [Medline].

  41. Eastlack JP, Howard RM, Frieden IJ. Congenital midline cervical cleft: case report and review of the English language literature. Pediatr Dermatol. 2000 Mar-Apr. 17(2):118-22. [Medline].

  42. Massa MC, Medenica M. Cutaneous adnexal tumors and cysts: a review. Part II--Tumors with apocrine and eccrine glandular differentiation and miscellaneous cutaneous cysts. Pathol Annu. 1987. 22 Pt 1:225-76. [Medline].

  43. Thaller SR, Bauer BS. Cysts and cyst-like lesions of the skin and subcutaneous tissue. Clin Plast Surg. 1987 Apr. 14(2):327-40. [Medline].

  44. Wick MR. Cystic lesions of the mediastinum. Semin Diagn Pathol. 2005 Aug. 22(3):241-53. [Medline].

All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.