Ch34P26-L4 Vellus Hair Cyst

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1. Histopathology of Inflammation

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F1Ch34: This is a cyst lined by stratified squamous epithelium; the keratinized debris is loosely laminated. Along the surface of the epithelial component, there are at least two indentations (near the top of the field). The blue arrow identifies a vellus hair that is cut in cross-section.


F2Ch34: This indentation, in the lining of the cyst, can be matched with one of the indentations seen in figure one. The epithelial column that projects to the left, and is in continuity with the indentation, is an immature follicle. Another follicle, to the right, is directed toward the cyst but is not in continuity on this section. By its direction - see figure one - it can be accepted as having continuity with (i.e., origin from) the lining of the cyst. In the component closest to the lining of the cyst, a vellus hair is present in the lumen of this small follicle. There is a thin layer of brightly acidophilic, keratinized debris along the surface of the epithelial lining of the cyst; beyond this layer, the keratinized debris is loosely laminated.


F3Ch34: At higher magnification, the vellus hair is visible in the lumen of the small follicle; the character of the epithelium, and the somewhat corrugated luminal surface suggests that this portion of the follicle has the epithelial characteristics of a sebaceous duct.


F4Ch34: This is the small follicle of figure one that is attached to the wall of the cyst. Anatomic divisions include an infundibulum, an isthmus (?), and an abortive bulb of basal cells. The lining of the cyst, as seen at the bottom of the field, has a thin surface layer of brightly acidophilic keratinized debris; in addition, the surface of the keratinized layer is slightly corrugated. The lining, and the contents of cyst are of a type seen in a steatocystoma, but other features influence the classification.


F5Ch34: These epithelial structures are attached to the lining of the cyst; the patterns are compatible with those seen in a resting follicle. This variation offers support for the interpretation that the small follicles of this vellus hair cyst, independently undergo cyclic changes in the manner of normal follicles.


F6Ch34: Two vellus hairs have been cut in cross-section. They are isolated among the keratinized lamellae in the lumen of the cyst.


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