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Imaging differential diagnosis Terminology Nabothian is generally written without capitalization, i. Clinical presentation The majority are asymptomatic, although in rare cases they can enlarge and become symptomatic 12 or present with vaginal discharge.
Pathology They represent retention cysts of the cervix that occur as a result of chronic inflammation and healing. They are thought to form as a result of the healing process of chronic cervicitis and represent mucinous cysts due to obstruction from an overgrowth of squamous epithelium. Symptomatic nabothian cysts can also occur as a late complication of subtotal hysterectomy, in which internalisation of the transformation zone and partial obliteration of the canal are postulated as predisposing factors.
Size Nabothian cysts are usually small spanning a few millimeters in diameter but on occasion, have been reported reach extreme sizes of up to 4 cm. Radiographic features Ultrasound Typically seen an anechoic well defined cystic lesions near the endocervical canal.
If the cysts are large, the cervical region can appear enlarged Color Doppler interrogation shows no associated color flow. CT If small may not be detectable on CT. May occasionally be seen as a focal low attenuation region within the cervical region.
MRI They may be seen as well-circumscribed single or multiple cystic lesions within the cervical stroma. Signal characteristics typically follow that of fluid 2. The majority of cases are not treated because the cysts are entirely benign; however, an excision biopsy is sometimes indicated in large, complex, cystic lesions to rule out rare forms of mucus-producing neoplasia, including adenoma malignum History and etymology Nabothian cysts were first described by Guillaume Desnoues — , a French surgeon in , who thought that they represented a store of spermatic-related substances.
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