title: A reappraisal of eyelid eccrine and apocrine hidrocystomas: microanatomic and immunohistochemical studies of 40 lesions.
abstract: OBJECTIVE
  To establish reliable criteria for diagnosing eyelid eccrine and apocrine hidrocystomas.
  
  
  METHODS
  Retrospective clinicopathologic and immunohistochemical study.
  
  
  METHODS
  Twenty-two specimens of normal portions of eyelids were evaluated to establish the distribution and microanatomy of eccrine and apocrine glands. Immunostaining for cytokeratin 7 (CK7), gross cystic disease fluid protein-15 (GCDFP-15), alpha-smooth muscle actin (α-SMA), epithelial membrane antigen (EMA), and carcinoembryonic antigen (CEA) was performed on these tissues and on 40 lesions in 33 patients diagnosed with eccrine or apocrine hidrocystomas by unaided light microscopy.
  
  
  RESULTS
  Eccrine glands were not present in the eyelid margins, the lower half of the upper eyelid pretarsal skin, or the pretarsal lower eyelid skin. Apocrine glands were restricted to the eyelid margins and canthi where the cysts were located. GCDFP-15, CK7, and α-SMA immunoreacted with the eccrine secretory coils but not their ducts; apocrine gland secretory spirals also stained positively for these markers throughout their extended courses, but not their short terminal ducts. Positivity was found in 37 of 40 hidrocystomas for α-SMA and 19 for GCDFP-15; lesions tested for CK7 displayed positivity.
  
  
  CONCLUSIONS
  Alpha-SMA-, CK7-, and/or GCDFP-15-positive apocrine hidrocystomas were the only type discovered in this series and arose from glandular secretory spirals within the marginal, perimarginal, or canthal skin. Three lesions did not stain for α-SMA, initially suggesting an absent myoepithelium and therefore an eccrine ductal origin; they manifested CK7 positivity, however, another characteristic of the apocrine secretory spiral but not ducts. Our findings disprove the contention that eccrine predominate over apocrine hidrocystomas in the eyelids.
authors.affiliation: David G. Cogan Laboratory of Ophthalmic Pathology, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, Massachusetts 02114, USA. Fred_Jakobiec@meei.harvard.edu
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Jakobiec
authors.forename: Fouad R
authors.initials: FR
authors.lastname: Zakka
mesh_terms: D000199:Actins / Q000378:metabolism; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001050:Apocrine Glands / Q000033:anatomy & histology* / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000378:metabolism; D002272:Carcinoembryonic Antigen / Q000378:metabolism; D002352:Carrier Proteins / Q000378:metabolism; D004439:Eccrine Glands / Q000033:anatomy & histology* / Q000378:metabolism; D005142:Eyelid Neoplasms / Q000378:metabolism / Q000473:pathology*; D005143:Eyelids / Q000033:anatomy & histology* / Q000378:metabolism; D005260:Female; D006023:Glycoproteins / Q000378:metabolism; D018251:Hidrocystoma / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007124:Immunoenzyme Techniques; D053552:Keratin-7 / Q000378:metabolism; D008297:Male; D026901:Membrane Transport Proteins; D008875:Middle Aged; D018396:Mucin-1 / Q000378:metabolism; D012189:Retrospective Studies; D013544:Sweat Gland Neoplasms / Q000378:metabolism / Q000473:pathology*
chemical_list: C541116:ACTA2 protein, human; D000199:Actins; D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D002352:Carrier Proteins; D006023:Glycoproteins; D053552:Keratin-7; D026901:Membrane Transport Proteins; D018396:Mucin-1; C488892:PIP protein, human