Cutaneous Columnar Cysts Workup

Updated: Aug 27, 2018
  • Author: Niels Holm, MB, BCh, MMEd(Derm), FCDerm(SA); Chief Editor: William D James, MD  more...
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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. [42]

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.