Professor Grosshans is correct when he includes median raphe cysts in the differential diagnosis of cystic lesions on the penis. Median raphe cysts, however,Formalin-fixed transmission electron microscopy (× 12,000). S indicates secretory granules. are lined by pseudostratified columnar epithelium or keratinizing epithelium,1,2 not by the secretory epithelium seen in this case. If one more closely examines the histologic picture of the case reported, a cyst lining of elongated cells with abundant eosinophilic cytoplasm and apparent decapitation secretion is seen. On hematoxylin-eosin staining, one is able to see a suggestion of secretory granules that are found to be PAS positive and diastase resistant. Closer examination discloses a small amount of pigment within these cells, which does not stain as melanin or hemosiderin and most likely represents lipochrome.3 These light-microscopic features may be seen in apocrine hidrocystoma,4 but not in median raphe cysts. Electron microscopy has been subsequently
Boddicker ME. Raphe Cyst or Apocrine Cystadenoma of the Glans Penis-Reply. Arch Dermatol. 1984;120(10):1279–1280. doi:10.1001/archderm.1984.01650460019005
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