Epidermoid metaplasia in apocrine cystadenoma of the penis. An ultrastructural analysis.

Two cystadenomas occurring near the frenulum of the penis revealed a predominantly secretory pseudostratified columnar epithelium with PAS-reactive dome-shaped cytoplasmic protrusions at the luminal cellular parts. The content of secretory vacuoles was discharged into the cyst lumen by an exocytotic (eccrine) and ballooning type of extrusion. There were no indications of a real apocrine extrusion mechanism. No histogenetic derivation of these penile cystadenomas from apocrine sweat glands could be proved. An antennalike filamentous fuzzy coat on the luminal cytoplasmic membrane was most remarkable. Regionally, an epidermoid differentiation had developed. Morphologically, this process had begun just above the basal cell layer which had remained unchanged and led to the establishment of a stratified epithelium. Hyalin lamellarlike flattened cells at the luminal part displayed necrobiotic features and resembled periderm cells. There was no keratin pattern. Luminal cells of epidermoid differentiation still revealed a filamentous fuzzy coat which indicated that the undifferentiated cuboidal basal cells basically had a prospective secretory meaning and probably represented the target cells in the process of metaplasia.