Pseudocyst of the Auricle Workup
- Author: William P Baugh, MD; Chief Editor: Dirk M Elston, MD more...
In several reports, magnetic resonance images revealed a serous fluid collection within the auricular cartilage, further enhancing the diagnosis.[8, 12]
Histologically, pseudocysts of the auricle lack pathognomonic features, but they can typically be characterized by an intracartilaginous cavity lacking an epithelial lining. They contain thinned cartilage and hyalinizing degeneration along the internal border of the cystic space. The epidermis and dermis overlying the pseudocyst are usually normal. However, a dermal perivascular lymphocytic infiltrate is commonly found, along with inflammatory cells within the cystic space.
In one of study, calcification of the auricular cartilage was identified at least 7 days after initial clinical presentation. Although contrary to literature reports,[10, 14, 15] one study postulated that an inflammatory response is crucial to the development of pseudocysts. This theory is based on a consistent perivascular inflammatory response seen in all 16 specimens studied. Eosinophilic degeneration and necrosis of the cartilage is also present in some areas. Intracartilaginous fibrosis and granulation tissues are manifestations of later stages of pseudocysts. A slide of an auricular pseudocyst is shown below.
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|Pseudocyst of the auricle||Chondrodermatitis chronica helices||Relapsing polychondritis||Subperichondrial hematoma|
|Skin involvement||Rare||Yes, crusting/ulceration||Yes, erythematous||Rare|
|Pain||Rare||Common (from ulceration)||Common (extremely tender)||Common|
|Systemic Symptoms||No||No||Yes (involvement of other cartilage)||No|
|Histology||racartilaginous, cystic defect, granulation tissue||Subperichondrial granulation tissue, cystic dilatation rare||Acute inflammable cells seen; antibody deposition on basement membrane during immunofluorescence||Inflammatory cells with degraded blood products|
|Adapted from Lim CM, et al. “Pseudocyst of the Auricle.” 2002.|