This article needs more reliable medical references for verification or relies too heavily on primary sources .(December 2017) |
Nabothian cyst | |
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Nabothian cyst | |
Specialty | Obstetrics and gynaecology |
A nabothian cyst (or nabothian follicle) [1] is a mucus-filled cyst on the surface of the cervix. They are most often caused when stratified squamous epithelium of the ectocervix (portion nearest to the vagina) grows over the simple columnar epithelium of the endocervix (portion nearest to the uterus). This tissue growth can block the cervical crypts (subdermal pockets usually 2–10 mm in diameter), trapping cervical mucus inside the crypts.
Nabothian cysts appear most often as firm bumps on the cervix's surface. A woman may notice the cyst when inserting a diaphragm or cervical cap, or when checking the cervix as part of fertility awareness. [2] [ unreliable medical source? ] A health care provider may notice the cysts during a pelvic exam.
Nabothian cysts are also incidentally found during MRI imaging. During the healing process of chronic cervicitis, squamous epithelium of ectocervix proliferates and enter the cervical canal (endocervix), covering and obstructing the columnar epithelium of endocervical glands. Thus, retention of mucus in the endocervical glands causes cyst formation. The size of the cyst may vary from a few millimetres to 4 cm in diameter. [3]
If a cyst has an unusual appearance, a colposcopy will be performed to rule out other diagnoses. [4] If the blood vessels are short, comma-like or corkscrew-shaped and bleed on contact, then the cyst may be a very rare mucin-producing carcinoma of the cervix. [4] Magnetic resonance imaging is used to distinguish cancer from the typical nabothian cyst. [4]
T1-weighted MRI imaging would show intermediate to high intensity while T2-weighted imaging would show high signal intensity. Findings of solid components separating multiple cysts would be suggestive of adenoma malignum (a form of cervical cancer). [3]
Nabothian cysts usually require no treatment and frequently resolve on their own. [4] Cryotherapy has been used to treat nabothian cysts but is rarely necessary. [4] Very rarely a cyst may be so large that it prevents a clinician from performing a pap smear, in which case the clinician may puncture the cyst with a needle and drain it. [4] If nabothian cysts occur with chronic cervicitis (inflammation of the cervix) then the underlying cause of the inflammation must be treated. [5] [6]
Nabothian cysts are also known as nabothian follicles, mucinous retention cysts, or epithelial inclusion cysts. They are named after German anatomist Martin Naboth (1675–1721), who wrote about them in a 1707 treatise titled De sterilitate mulierum. However, they were earlier described by French surgeon Guillaume Desnoues (1650–1735). [7] [ better source needed ] Since it is a derived term, nabothian is not spelled with a capital first letter.
The cervix or cervix uteri is the lower part of the uterus (womb) in the human female reproductive system. The cervix is usually 2 to 3 cm long and roughly cylindrical in shape, which changes during pregnancy. The narrow, central cervical canal runs along its entire length, connecting the uterine cavity and the lumen of the vagina. The opening into the uterus is called the internal os, and the opening into the vagina is called the external os. The lower part of the cervix, known as the vaginal portion of the cervix, bulges into the top of the vagina. The cervix has been documented anatomically since at least the time of Hippocrates, over 2,000 years ago.
The Papanicolaou test is a method of cervical screening used to detect potentially precancerous and cancerous processes in the cervix or colon. Abnormal findings are often followed up by more sensitive diagnostic procedures and, if warranted, interventions that aim to prevent progression to cervical cancer. The test was independently invented in the 1920s by the Greek physician Georgios Papanikolaou and named after him. A simplified version of the test was introduced by the Canadian obstetrician Anna Marion Hilliard in 1957.
The Bartholin's glands are two pea sized compound alveolar glands located slightly posterior and to the left and right of the opening of the vagina. They secrete mucus to lubricate the vagina.
Epithelium or epithelial tissue is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. It is a thin, continuous, protective layer of compactly packed cells with a little intercellular matrix. Epithelial tissues line the outer surfaces of organs and blood vessels throughout the body, as well as the inner surfaces of cavities in many internal organs. An example is the epidermis, the outermost layer of the skin.
A bronchus is a passage or airway in the lower respiratory tract that conducts air into the lungs. The first or primary bronchi to branch from the trachea at the carina are the right main bronchus and the left main bronchus. These are the widest bronchi, and enter the right lung, and the left lung at each hilum. The main bronchi branch into narrower secondary bronchi or lobar bronchi, and these branch into narrower tertiary bronchi or segmental bronchi. Further divisions of the segmental bronchi are known as 4th order, 5th order, and 6th order segmental bronchi, or grouped together as subsegmental bronchi. The bronchi, when too narrow to be supported by cartilage, are known as bronchioles. No gas exchange takes place in the bronchi.
Cervicitis is inflammation of the uterine cervix. Cervicitis in women has many features in common with urethritis in men and many cases are caused by sexually transmitted infections. Non-infectious causes of cervicitis can include intrauterine devices, contraceptive diaphragms, and allergic reactions to spermicides or latex condoms. Cervicitis affects over half of all women during their adult life.
Antepartum bleeding, also known as antepartum haemorrhage (APH) or prepartum hemorrhage, is genital bleeding during pregnancy after the 28th week of pregnancy up to delivery.
Cervical intraepithelial neoplasia (CIN), also known as cervical dysplasia, is the abnormal growth of cells on the surface of the cervix that could potentially lead to cervical cancer. More specifically, CIN refers to the potentially precancerous transformation of cells of the cervix.
Cervical stenosis means that the opening in the cervix is more narrow than is typical. In some cases, the endocervical canal may be completely closed. A stenosis is any passage in the body that is more narrow than it should typically be.
The cervical canal is the spindle-shaped, flattened canal of the cervix, the neck of the uterus.
A dentigerous cyst, also known as a follicular cyst, is an epithelial-lined developmental cyst formed by accumulation of fluid between the reduced enamel epithelium and the crown of an unerupted tooth. It is formed when there is an alteration in the reduced enamel epithelium and encloses the crown of an unerupted tooth at the cemento-enamel junction. Fluid is accumulated between reduced enamel epithelium and the crown of an unerupted tooth.
Cervical ectropion is a condition in which the cells from the 'inside' of the cervical canal, known as glandular cells, are present on the 'outside' of the vaginal portion of the cervix. The cells on the 'outside' of the cervix are typically squamous epithelial cells. Where the two cells meet is called the transformation zone, also known as the stratified squamous epithelium. Cervical ectropion can be grossly indistinguishable from early cervical cancer and must be evaluated by a physician to determine risks and prognosis. It may be found incidentally when a vaginal examination is done. The area may look red because the glandular cells are red. While many women are born with cervical ectropion, it can be caused by a number of reasons, such as:
Vaginal cancer is an extraordinarily rare form of cancer that develops in the tissue of the vagina. Primary vaginal cancer originates from the vaginal tissue – most frequently squamous cell carcinoma, but primary vaginal adenocarcinoma, sarcoma, and melanoma have also been reported – while secondary vaginal cancer involves the metastasis of a cancer that originated in a different part of the body. Secondary vaginal cancer is more common. Signs of vaginal cancer may include abnormal vaginal bleeding, dysuria, tenesmus, or pelvic pain, though as many as 20% of women diagnosed with vaginal cancer are asymptomatic at the time of diagnosis. Vaginal cancer occurs more frequently in women over age 50, and the mean age of diagnosis of vaginal cancer is 60 years. It often can be cured if found and treated in early stages. Surgery alone or surgery combined with pelvic radiation is typically used to treat vaginal cancer.
Cock's peculiar tumour is a sebaceous cyst linked growth that can resemble a squamous cell carcinoma. The name is given after a 19th-century English surgeon Edward Cock. The proliferating cyst is usually solitary, but it often arises from a simple trichilemmal cysts in the hair follicle epithelium and these are multiple in 70% of cases. They are most commonly found on the scalp where the proliferating trichilemmal cyst will grow to a large size and ulcerate. Chronic inflammation can cause the cyst to take the form of a granuloma. This granuloma mimics a squamous-cell carcinoma and these ulcerating solitary cysts are called Cock's peculiar tumour.
Neuroendocrine carcinoma of the cervix is best defined separately:Neuroendocrine: Of, relating to, or involving the interaction between the nervous system and the hormones of the endocrine glands.Carcinoma: An invasive malignant tumor derived from epithelial tissue that tends to metastasize to other areas of the body.
Cervical cancer staging is the assessment of cervical cancer to determine the extent of the disease. This is important for determining disease prognosis and treatment. Cancer staging generally runs from stage 0, which is pre-cancerous or non-invasive, to stage IV, in which the cancer has spread throughout a significant part of the body.
Fertility testing is the process by which fertility is assessed, both generally and also to find the "fertile window" in the menstrual cycle. General health affects fertility, and STI testing is an important related field.
Microglandular hyperplasia (MGH) of the cervix is an epithelial benign abnormality (lesion) associated with gland proliferation. It can terminate in mature squamous metaplasia, and it is suspected reserve cells are involved in this process, perhaps in the form of reserve cell hyperplasia with glandular differentiation.
The vaginal epithelium is the inner lining of the vagina consisting of multiple layers of (squamous) cells. The basal membrane provides the support for the first layer of the epithelium-the basal layer. The intermediate layers lie upon the basal layer, and the superficial layer is the outermost layer of the epithelium. Anatomists have described the epithelium as consisting of as many as 40 distinct layers. The mucus found on the epithelium is secreted by the cervix and uterus. The rugae of the epithelium create an involuted surface and result in a large surface area that covers 360 cm2. This large surface area allows the trans-epithelial absorption of some medications via the vaginal route.
Vaginal cysts are uncommon benign cysts that develop in the vaginal wall. The type of epithelial tissue lining a cyst is used to classify these growths. They can be congenital. They can present in childhood and adulthood. The most common type is the squamous inclusion cyst. It develops within vaginal tissue present at the site of an episiotomy or other vaginal surgical sites. In most instances they do not cause symptoms and present with few or no complications. A vaginal cyst can develop on the surface of the vaginal epithelium or in deeper layers. Often, they are found by the woman herself and as an incidental finding during a routine pelvic examination. Vaginal cysts can mimic other structures that protrude from the vagina such as a rectocele and cystocele. Some cysts can be distinguished visually but most will need a biopsy to determine the type. Vaginal cysts can vary in size and can grow as large as 7 cm. Other cysts can be present on the vaginal wall though mostly these can be differentiated. Vaginal cysts can often be palpated (felt) by a clinician. Vaginal cysts are one type of vaginal mass, others include cancers and tumors. The prevalence of vaginal cysts is uncertain since many go unreported but it is estimated that 1 out of 200 women have a vaginal cyst. Vaginal cysts may initially be discovered during pregnancy and childbirth. These are then treated to provide an unobstructed delivery of the infant. Growths that originate from the urethra and other tissue can present as cysts of the vagina.
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