PATHOLOGY OF THE ANAL GLANDS WITH SPECIAL REFERENCE TO THEIR MUCIN HISTOCHEMISTRY

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Abstract
The anal gland pathology comprises cystic anal glands (so-called anal gland cyst hamartomas), anal gland carcinomas, and anal fistulas with or without carcinoma. The differential diagnosis of these conditions from other cysts and carcinomas of the anal region can be difficult. Conventional histology was compared with mucin histochemistry in normal and pathological anal glands. In contrast to normal rectal mucosa the mucus of anal glands was characterized by strong PAS[periodic acid-Schiff]-reactivity that was completely abolished after periodate borohydride saponification indicating scarcity or absence of O-acylated sialic acids in the anal gland mucus. A pattern similar to this was found in 1 of 2 tumors classified histologically as anal gland carcinomas in 4 of 8 colloid carcinomas arising from preexisting fistulas, and in 2 cases of mucoepidermoid carcinoma of the anal region. The method in some cases may be of value in differentiating between carcinomas arising in anal gland epithelium and in rectal mucosa. The cystic anal glands showed decreased secretion but no qualitative histochemical differences from anal glands. On the basis of the patients'' histories it is suggested that the so-called anal gland cyst hamartoma at least in some cases could be an inclusion cyst of anal glands on an inflammatory basis.