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Sweat gland cysts: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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Sweat gland cysts (syn. hydrocystomas) arise from eccrine or apocrine glands.
The clinical picture of hydrocysts of any origin is quite similar, there are only histological differences. Clinically, they are small, with a bluish tint and a shiny surface, cystic elements that occur mainly on the face. Cysts of the apocrine type, mostly solitary, rarely multiple.
Pathomorphology of sweat gland cysts. Eccrine hydrocystoma refers to intradermal cysts, covered with one or two rows of prismatic or flattened cells. On serial sections, their connection with dilated ducts of sweat glands can be observed. Unlike apocrine hydrocystomas, there are no papillomatous outgrowths into the cyst lumen, as well as myoepithelial cells.
Apocrine cysts are covered with prismatic or columnar epithelium with a distinct apical type of secretion and basally located small myoepithelial cells with dark-stained nuclei. Secretory cells contain large diastase-resistant PAS-positive granules. In the surrounding stroma there are small-point hemorrhages with hemosiderin deposits, macroscopically creating a bluish tint to the cyst.
Histogenesis. Electron microscopy revealed numerous lysosomal and secretory granules, large, irregularly shaped mitochondria and lamellar bodies in the cells of apocrine cysts. The absence of retention cysts indicates a connection between apocrine hydrocystoma and apocrine glands.
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