Title: Pigmented bartholin duct cyst: An extremely unusual presentation of a relatively common lesion. a review of pigmented cystic lesions in anogenital area
Biography: Ali Moghimi
Bartholin gland cyst results from dilatation of the Bartholin duct due to obstruction. Pigmentation in an external genital cyst, such as median raphe cyst, has been previously reported. However, presence of melanocytes or melanin pigment in the cyst wall of Bartholin duct cysts is an extremely rare finding, with only one case reported in the literature. Herein, I report the second case of pigmented Bartholin duct cyst with a brief review on pigmented cystic lesions in anogenital area. An 18-year-old lady presented with small pigmented papule in vulva, clinically resembling haematoma. The biopsy identified squamous mucosa with underlying stroma showing cystic spaces, lined by single or double layers of cuboidal to flat epithelium. Some epithelial cells contained brown pigment granules in their cytoplasm and there were also pigments within the surrounding stroma as well as the lumina of cystic spaces. The melanocytes within the epithelium of the cyst were stained by Melan-A, SOX10, MIT1 and S100 immunoperoxidase stains. A diagnosis of pigmented Bartholin duct cyst was rendered. This is the second documented case of pigmented Bartholin duct cyst in the literature. The first was a 41-year-old Japanese female who presented with an asymptomatic nodule in the external genitals, showing features similar to this case. The mechanism of pigmentation has not been elucidated and there are no malignant features associated with this finding. However, it is important for reporting pathologist to be aware of this variant in order to avoid misinterpretation of the findings as an atypical melanocytic lesion.