Thursday, November 11, 2010

Multiple Nabothian cysts of the cervix

This middle aged woman presented with irregular menses. Transvaginal ultrasound (see video clip above) shows multiple cysts of the cervix (transverse section of the cervix). This is the typical appearance of Nabothian cysts of the cervix. Nabothian cysts are also called mucinous retention cysts or Nabothian follicles of the cervix and are usually of little clinical significance unless complicated by infection or if they become unusually large. Most such cysts usually disappear without medical treatment. 
Here is a sagittal section ultrasound video of the same cervix (transvaginal):

As stated above, these Nabothian cysts of the cervix do not appear ominous in any way. However, the cause of this patient's complaints appear to be due to (see ultrasound images below):

The endometrium (the inner lining of the uterus) is seen to be markedly thickened (at 13 mm.). On color Doppler imaging of the uterus (both transabdominal and transvaginal), the endometrium does not show any vascular areas or increased blood flow within any part of it. This kind of thickening of the endometrium is called endometrial hyperplasia and needs further investigation. A pap smear of the cervical fluid showed some degree of squamous metaplasia. This patient needs to be monitored and might need treatment for the hyperplastic changes in the endometrium. 
For more ultrasound and color Doppler images of uterine pathology see:

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