Gland Cyst Research Articles

Rapid, noninvasive screening of ocular diseases using tear raman spectroscopy and different classification algorithms

This study presents a rapid, noninvasive method for screening of ocular diseases using tear Raman spectroscopy combined with different classification algorithms. Tear samples from 69 patients with ocular disease (including 14 cases of conjunctivitis tears, 17 cases of blepharitis tears, 10 cases of meibomian gland cyst tears, 18 cases of cataract tears, and 10 cases of glaucoma tears) and 48 healthy volunteers were measured in this experiment. In the measured tear spectrum, the tentative assignment of Raman peaks indicates specific biomolecular changes between the groups. First, partial least squares (PLS) and principal component analysis were used to extract features and greatly reduce the dimension of the spectral data. Then support vector machine (SVM) and back-propagation neural network algorithms were used to establish a discriminant diagnosis model. Finally, the best diagnostic results were obtained from the PLS-SVM model with accuracy, specificity, and sensitivity of 85.71%, 100%, and 76.19%, respectively. Our results suggest that tear Raman spectroscopy combined with multivariate statistical methods has great potential for screening for ocular diseases.

A clinicopathological classification analysis of ocular mass lesions in 7 910 cases

Objective: To investigate the anatomical region, histopathological classification and histogensis distribution of ocular mass lesions in South China. Methods: Retrospective cases study. The clinical and pathological data of 7 910 samples with ocular (adnexal) tumors or proliferative lesions which were examined from January 2000 to May 2018 were retrospectively retrieved. The constituent ratios of ocular mass lesions in different anatomical regions and histogenesis have been analyzed. Results: There were 3 445 males and 4 465 females aged from 3 months to 106 years. Classification by anatomical region. Eyelid 4 976 cases (62.9%): benign-pigmented nevus (31.7%, 1 342/4 235), squamous cell papilloma (12.3%, 519/4 235), seborrheic keratosis (9.4%, 396/4 235); malignant-basal cell carcinoma (48.5%, 359/741), sebaceous gland carcinoma (34.4%, 255/741), squamous cell carcinoma (12.3%, 91/741). Ocular surface 1 449 cases (18.3%): benign-pigmented nevus (26.6%, 359/1 348), squamous cell papilloma (12.8%, 173/1 348); malignant-lymphoma (34.7%, 35/101), squamous cell carcinoma (30.7%, 31/101).Orbit 1 485 cases (18.8%): benign-hemangioma (28.5%, 332/1 167), lacrimal gland (duct) cyst(13.2%, 154/1 167); malignant-lymphoma (44.7%, 142/318), adenoid cystic carcinoma (10.1%, 32/318). Classification by histogenesis: epithelial 2 145 cases (27.1%), cutaneous appendages 378 cases (4.8%), cystoid 1 068 cases (13.5%), mesenchymal 748 cases (9.5%), lymph-hematopoietic 225 cases (2.8%), neurogenic 31 cases (0.4%), melanocytic 1 765 cases (22.3%), others 1 550 cases (19.6%). Conclusions: Over the past 18 years, the ocular tumors identified at the Second Affiliated Hospital, Zhejiang University School of Medicine most frequently occur in eyelid and originate from epithelium. The most common types are as followings. Benign lesions: pigmented nevus, squamous cell papilloma are the most common types for eyelid and ocular surface, whereas hemangioma, lacrimal gland (duct) cyst and epidermoid cyst are the most common types for orbit. Malignant cancers: basal cell carcinoma is the most prevalent disease in eyelid, whereas lymphoma occurs more frequently in ocular surface and orbit. (Chin J Ophthalmol, 2019, 55: 847-853).

Bartholin Gland Cyst Educational Simulation Improves Knowledge and Confidence

PROBLEM: Our institution had an increasing number of ER consults for recurrent Bartholin gland cysts/abscesses between May of 2015 and June of 2016. The majority had incorrect placement of the incision and drainage site or limited or improper Word catheter use. Ob/Gyn, Family Medicine, and ER departments did not have specific training available for this diagnosis and treatment. INTERVENTION: We developed a simulation-based curriculum including a didactic presentation on Bartholin gland cyst/abscess diagnosis and treatment options, an instructional video demonstrating the steps of Bartholin gland cyst/abscess drainage with Word catheter placement, and supervised practice on an established Bartholin gland cyst model with feedback. Learner knowledge and confidence were assessed before and after the curriculum, and satisfaction with the simulation model for both I&D and Word catheter placement were assessed after the curriculum. CONTEXT: UTMCK has residencies for Ob/Gyn and Family Medicine with protected education time. There is an ER fellowship but most ER providers are ER physicians and PA’s with limited time for group learning. OUTCOME/LESSONS LEARNED: Implementation with 26 Ob/Gyn residents and 5 medical students showed increases in learner confidence and some aspects of knowledge. Participants were highly satisfied with the simulation model. Curriculum delivery will need to be tailored to the different specialties. Family Medicine residents are scheduled to complete the group training in January 2019 but the ER providers have requested to complete the training as self-study modules due to shift restrictions.

Leiomyosarcoma: A Rare Tumor of the Vulva

Abstract Objective Primary sarcomas of the vulva are very rare malignancies, accounting for 1% to 3% of all gynecologic sarcomas. Leiomyosarcoma is the most common histologic type. They present with nonspecific symptoms, aggressive behavior, and high metastatic potential. Methods A 63-year-old female patient presented with a 6-month history of a slow-growing, painless vulvar mass at the right posterior fourchette. CT scan revealed an asymmetric, heterogeneous vulvar mass extending to the distal vagina, without lymphadenopathy or evidence of distant metastasis. Focal prominence of the uterus suggestive of leiomyoma was also noted, but primary uterine neoplasm with vulvar metastasis could not be excluded. The patient underwent wide local excision of the vulvar mass with hysterectomy and bilateral salpingo-oophorectomy. Results Gross examination of the vulvar specimen showed an ulcerated 2.1-cm solid white mass with irregular borders. Microscopically, the vulvar tumor consisted of a focally infiltrative spindle and pleomorphic neoplastic proliferation with interlacing fascicular pattern and increased mitotic activity up to 25/10 HPF, without necrosis or lymphovascular invasion. The tumor focally extended to resection margins. Immunohistochemically, the neoplastic cells were positive for SMA, ER, and desmin and negative for S-100 and cytokeratin AE1/AE3. These findings, in conjunction with the clinical presentation, were consistent with high-grade primary vulvar leiomyosarcoma. Radiation therapy was subsequently started. Conclusion Primary vulvar leiomyosarcomas are rare and secondary involvement by uterine primary should always be ruled out. In addition, these tumors can be mistaken clinically as benign processes such as Bartholin gland cysts, infectious granuloma, fibroma, or myoma. Hence, it is vital to consider vulvar sarcomas in the differential diagnosis of nonspecific vulvar lesions in order to avoid delay in diagnosis and treatment. The rarity of this diagnosis makes this case worth reporting.

A case of ectopic bronchogenic cyst in the stomach and a review of relevant literature

Bronchogenic cyst is a type of residual embryonic cystic gland resulting from bronchial dysfunction during embryonic development. It is a disease caused by abnormal development. Ectopic bronchogenic cysts are rarely encountered in clinical practice. Their growth rate is usually slow, and the onset is insidious. These cysts mostly develop into diseases after the patient reaches adulthood. The clinical symptoms are not typical. Computed tomography (CT) can assist in diagnosis, although the final diagnosis requires pathology. Bronchogenic cysts rarely have malignant development, and surgical resection is the only method for treating this disease. Cysts should be completely removed with the capsule to the fullest extent possible during surgery. There is currently no reported case of recurrence and metastasis when the cyst has ruptured.

Histological analysis of fundic gland polyps secondary to PPI therapy.

The aim of this study was to clarify the histopathological features of fundic gland polyps (FGPs) in patients treated with proton pump inhibitors (PPIs) and to investigate the mechanism of enlargement of FGPs after PPI treatment. A total of 196 biopsy specimens of FGPs, which consisted of 87 FGPs in patients treated with PPIs (PPI group) and 109 FGPs in patients treated without PPIs (non-PPI group) were compared histologically using haematoxylin and eosin staining, Ki67 immunohistochemistry and multiplex immunohistochemical stain with Ki67, MUC5AC and MUC6. The significant histological features of FGPs in the PPI group were: larger size of dilated fundic gland cysts, larger number of foveolar and mixture type fundic gland cysts, foveolar cell hyperplasia, parietal cell protrusion, mononuclear cell infiltration and a higher percentage of Ki67-positive cells in the deeper layers of the glands. Multiplex immunohistochemical stain showed that Ki67-positive cells were also positive for MUC5AC, and the Ki67-positive rate was significantly higher in MUC5AC-positive cells of the PPI group than of the non-PPI group. Gene mutations of β-catenin were found in only 9.7% of FGPs in the PPI group. Enlargement of fundic gland cysts due to foveolar cell proliferation and parietal cell protrusion might promote the enlargement of FGPs in patients treated with PPIs. β-catenin gene mutations might not be associated with these histological changes of FGPs after PPI treatment.

Beauty is only mucosa deep: a retrospective analysis of oral lumps and bumps caused by cosmetic fillers.

Introduction The injection of dermal fillers into orofacial tissues is becoming increasingly popular for cosmetic purposes, in particular for lip augmentation. Both natural and synthetic filler materials are available, producing a spectrum of clinical and histological appearances.Aims The aim of this study was to review the clinicopathological characteristics of dermal filler cases from 2006 to 2016, reported at a specialist oral pathology unit.Methods An archival search of the pathology database was performed to retrieve cases reported as being consistent with cosmetic fillers.Results Ten cases of orofacial cosmetic fillers were retrieved. Of these cases, 100% were from female patients and the mean age of presentation was 47.6 years (range 24-68 years). The lips were the most frequently involved site (80%, n = 8). The majority of provisional diagnoses were related to salivary gland disease, including neoplasms (30%, n = 3), cysts (20%, n = 2) or inflammatory disease (10%, n = 1). Only two cases (20%) were clinically thought to be related to previous cosmetic injections. A variety of filler materials were seen, including collagen, hydroxyapatite and silicone. However, hyaluronic acid-based materials were the most common (50%, n = 5).Conclusions Complications of cosmetic dermal fillers are becoming more common and should be considered within a differential diagnosis for unusual orofacial swellings.

Endoscopic findings of esophageal submucosal gland duct adenoma.

Endoscopic findings of esophageal submucosal gland duct adenoma.

An assessment of vertigo patients presenting to the otorhinolaryngology and neurology outpatient clinics

Objective: Vertigo is a general term used for disorientation and is a frequent cause of admission to emergency services, otorhinolaryngology and neurology outpatient clinics. This study aims to evaluate the clinical findings, diagnostic laboratory tests, brain magnetic resonance imaging, and Doppler ultrasonography results of patients with complaints of vertigo. Methods: Patients aged >18 years who admitted to the Otorhinolaryngology and Neurology Outpatient clinics of Kahramanmaraş Sütçü İmam University Training and Research Hospital with the main complaint of vertigo between January 2017 and August 2017 were retrospectively reviewed. The patients were evaluated in respect of anamnesis, examination findings, and diagnostic tests (pure tone audiometry, video nystagmography, brain magnetic resonance imaging, and carotid and vertebral artery Doppler ultrasonography). Results: The study included a total of 101 patients with a mean age of 46.36 ± 16.1 years who presented with the complaint of vertigo. Of the patients, 16 had an ischemic gliotic region, 4 had a lacunar infarct, 2 had an arachnoid cyst, 2 had a cerebellar infarct, 1 had a meningioma, and 1 had a pineal gland cyst on the brain magnetic resonance imaging. Of the patients evaluated in the Otorhinolaryngology outpatient clinic, 87 (86.13%) were diagnosed with peripheral vertigo and 14 (13.6%) with central vertigo. A diagnosis of central vertigo was made in 23 (22.77%) patients evaluated in the Neurology outpatient clinic. Conclusions: For patients presenting with the complaint of vertigo to the otorhinolaryngology and neurology outpatient clinics, a detailed anamnesis and a physical examination precede specific vestibular tests in the diagnosis. A coordinated communication of both clinics is important for a rapid diagnosis and prevention of unnecessary examinations.

Intralymphatic Rosai-Dorfman Disease Associated With Vulvar Lymphedema: A Case Report of an Extremely Rare Phenomenon

Sinus histiocytosis with massive lymphadenopathy, also known as Rosai-Dorfman disease (RDD), is a self-limited histiocytic disorder of unclear etiology which most commonly presents with cervical lymphadenopathy. Purely extranodal presentation of RDD is uncommon, and isolated intralymphatic/intravascular confinement of this entity has not previously been described. We report a 16-yr-old female who presented with vaginal swelling and mass-like enlargement of the right labia. The mass had been present for nearly a year without pain or tenderness. Clinically, the lesion was thought to be a Bartholin gland cyst. Following surgical resection, histologic examination demonstrated a hypocellular myxedematous stroma with a mixture of ectatic thin and thick-walled vessels within which there were numerous collections of histiocytes, lymphocytes, and plasma cells. The histopathologic differential diagnosis included localized vulvar lymphedema, a specialized genital tract neoplasm, and childhood asymmetric labium majus enlargement. The histiocytes showed occasional plasma cells and lymphocytes within their cytoplasm, consistent with emperipolesis. Immunohistochemical studies showed that the histiocytes expressed CD163 and S100, while ERG and D2-40 highlighted their intralymphatic confinement, ultimately leading to the diagnosis of intralymphatic RDD. Intralymphatic RDD may present as vulvar lymphedema and can potentially mimic other myxedematous neoplasms of the vulvovaginal region.

Primary pseudomyogenic hemangioendothelioma of the vulva: a rare location for a rare entity

BackgroundPseudomyogenic hemangioendothelioma (PMHE) is a recently described vascular neoplasm which typically occurs in the lower extremities of young to middle-aged adults.Case presentationWe present here a unique case of PMHE arising primarily in the vulva of a 51-year-old woman who presented with a painful vulvar nodule. Clinically, it was thought as Bartholin gland cyst, vulvar hematoma or papilloma. On surgery, two nodules were found with one located in the superficial dermis and the other in the deep subcutis. Histologically, these two nodules showed similar features, composed of fascicles or sheets of plump spindled to epithelioid cells with eosinophilic cytoplasm. Given the morphological resemblance to a myogenic tumor, the lesion was initially diagnosed as a rhabdomyosarcoma by the referring pathologist. However, a comprehensive reevaluation of the submitted slides made us reconsider a PMHE, which was subsequently confirmed by immunohistochemical study.ConclusionThis case demonstrates that PMHE can also develop in the female external genitalia albeit extremely rare. This disease should be included in the differential diagnostic list of vulvar tumors with spindled to epithelioid morphology and cytokeratin-positive immunophenotypes.

RETROSPECTIVE ANALYSIS OF MORTALITY IN CAPTIVE BONGO (TRAGELAPHUS EURYCERUS), 1995–2015

A retrospective histologic study was performed for 96 deceased bongo (Tragelaphus eurycerus) submitted to Northwest ZooPath from 1995 to 2015. Histologic data were assessed for associations with sex, age, cause of death/euthanasia, and affected organ systems. Female bongo lived significantly longer than males. Males were more likely to die from infectious causes (41.2%), whereas most females died from chronic noninfectious conditions (54.4%) and trauma/stress (28.1%). Of those that died from infectious disease, the respiratory tract was the most commonly affected organ system. The most common infectious agents included acid-fast bacteria and fungi. Chronic conditions included amyloidosis (31.0%), inanition/emaciation (23.8%), and neoplasia (21.4%). Of the 31 animals that died with amyloidosis, 58% appeared to be clinically affected, and amyloidosis was likely an underlying cause of death in 42% of the animals. The most commonly affected organs included the liver, kidneys, adrenal glands, and gastrotintestinal tract. Also noteworthy was a high prevalence of adrenal gland hyperplasia and neoplasia, cystic thyroid glands, and aspiration pneumonia, which were not consistently associated with a prior anesthetic event or other obvious predisposing cause.

Surgical management of Bartholin cysts and abscesses in French university hospitals

Objectives: To assess the methods used to manage Bartholin gland abscesses and cysts in French university hospitals.Method: Data for this descriptive, cross-sectional study with self-reported data were collected between January and March 2018 by an online questionnaire. The 11 items of the questionnaire assessed the surgical techniques known and used, the type of hospitalization, and the non-surgical management to treat Bartholin gland abscesses and cysts.Results: Overall, 116 obstetrics-gynecology residents responded to the online questionnaire. The three best-known techniques were incision and drainage, marsupialization, and excision of the Bartholin gland. Only 3% of the physicians knew about other techniques. Most participants reported that their unit treated 2–6 Bartholin gland abscesses monthly and fewer than 2 cysts. The most frequent treatment for abscess was incision-drainage (87%), followed by marsupialization (13%). The most widely used treatment for the cysts was gland excision (68.5%) followed by marsupialization (22.5%). In both cases, management generally took place on an outpatient basis (92.9%).Conclusion: This study showed that 87% of the respondents used incision-drainage for Bartholin gland abscesses, although the recurrence and complication rates of this technique have never been evaluated.

Blood parasite infection causing inflammatory reactions and benign formations in human thyroid gland

A retrospective examining of cytology specimens obtained and verified by a fine-needle aspiration biopsy from patients with autoimmune thyroiditis and benign thyroid gland (cyst and goiter) formations allowed to note that in thyroid lobes they coincided in various combinations, thus rising a question about their potential etiological relation. In particular, a hemosporidian (blood parasitic) infection was found while analyzing cytology specimens from patients with autoimmune thyroiditis and benign thyroid gland (cyst and goiter) tumors prestained by Romanowsky-Giemsa dye. An evolution of developing intra-thyrocyte hemosporidia was tracked during a long-term detailed analysis of cytology specimens noted above. A panel of select specimens was stained (re-stained) with Schiff reagent according to the Feulgen method to clarify position of thyrocyte DNA and hemosporidian pathogens. Owing to an absorption approach, Romanovsky-Giemsa method allowed to repeatedly use specimens pre-stained with Schiff reagent according to the Feulgen method, wherein fuchsine was incorporated into DNA molecules after they were hydrolyzed by hydrochloric acid to stain specimens into magenta-lilac color. It allowed to identify a parasitic DNA inside developing hemosporidia most probably at exoerythrocytic stage and some erythrocytes cyst-based medusiform structures. Such technique used to stain specimens from patients with autoimmune thyroiditis allowed to localize the thyrocyte nuclear DNA as well as punctate and diffuse cytoplasmic inclusions of parasitic DNA, including magenta-lilac nuclei of different sizes inside erythrocytes. Thyrocyte nuclear DNA as well as punctate and diffuse hemosporidian DNA were distinguished in nodular goiter. Moreover, hemosporidian DNA was identified in a form of magenta-lilac multi-size nuclei inside erythrocytes. In contrast, unstained hemosporidian protoplasm was revealed as light-colored band around erythrocyte nuclei. The intra-erythrocyte nuclear hemosporidian material of different sizes may evidence about various species and/or pathogen generations. Intra-thyrocyte development of hemosporidian infection in patients with goiter results in marked cytoplasmic hyperplasia and its vacuolization associated with thyrocyte nuclear deformation, vacuolization, decreased size and degradation (with highly probability of mutations and deletions), reaching a pre-neoplastic level.

A case of gigantic multiple lymphoepithelial cysts in both parotid glands

A case of gigantic multiple lymphoepithelial cysts in both parotid glands

Ectopic Thyroid Tissue in Submandibular Region

Ectopic thyroid is the presence of gland at any location except for its normal position in the anterior neck in front of the trachea. It may result from an early arrest of migration or migration along an abnormal path. Ectopic thyroid in the submandibular region is relatively unusual and may or may not be accompanied with the orthotopically located thyroid gland. Pathological changes reported in the literature in the ectopic gland include goitrous change, hyperplasia, malignancy, and, rarely, inflammation. Patients usually present as a palpable, mobile, and painless mass below the lateral jaw. The important differentials include salivary gland tumor, lymphoma, inflammatory lymphadenopathy, lipoma, and cysts. Ultrasonography, radionuclide scan, computed tomography, and magnetic resonance imaging are the diagnostic modalities for documenting the presence of ectopia. Evaluation of functional status with thyroid profile and histopathological examination after fine-needle aspiration cytology directs further management. Surgical removal is the preferred treatment for ectopic thyroid. Thyroidectomy predisposes the patient to iatrogenic hypothyroidism if eutopic thyroid is absent or hypofunctioning. Such patients require lifelong thyroid replacement. However, asymptomatic cases may be managed conservatively. Ectopic thyroid in the submandibular region has important clinical implications and hence, even though rare, should be considered as one of the differentials in the patient presenting with swelling below the lateral jaw.

Angiomyofibroblastoma: Imaging and histopathology of a rare benign mesenchymal tumor

Angiomyofibroblastomas, aggressive angiomyxomas and cellular angiofibromas are rare mesenchymal tumours with many overlapping radiological, histopathological and immunohistochemical features. Amongst these tumours angiomyofibroblastoma is relatively benign mesenchymal tumour with very low chances of recurrence. It is clinically confused with bartholin gland cyst due to its well demarcated and smooth appearance. Due to overlapping histopathological features its very difficult even for experienced pathologists to differentiate between these mesenchymal tumours. Earlier desmin reactivity was thought to be specific for angiomyofibroblastoma but recently many aggressive angiomyxomas have also been found to be positive for desmin. Ultrasound, computed tomography and magnetic resonance imaging may be useful in diagnosis and ruling out more sinister malignancies. A well demarcated lesion with characteristic histopathological appearance of alternating hypo and hypercellular edematous regions with abundant blood vessels and stromal cells with dispersed chromatin is usually seen in angiomyofibroblastoma. Immunohistochemistry may further help in diagnosis. We here report a case of vaginal angiomyofibroblastoma. The diagnosis was made on the basis of imaging and was confirmed by histopathology and immunohistochemistry.

Prikaz slučaj epitelijalne nadbubrežne ciste

Introduction: Adrenal gland cysts are relatively rare cystic lesions, which are usually discovered incidentally with the widespread use of radiological imaging techniques. Case report: We reported a clinical case of a 36-year -old woman who presented with a 6 months history of right flank discomfort. The contrast-enhanced abdominal computed tomography revealed a well-circumscribed cystic lesion with a capsule in the Morrison's pouch measuring 57 x 51 mm. On abdominal magnetic resonance imagining (MRI), the cystic lesion exhibited a hypointensity on T-1 weighted images and hyperintensity on T-2 weighted images. Surgery was decided because of lesion size and doubts concerning its etiology. The final histopathological diagnosis was an epithelial cyst of the adrenal gland. In summary, epithelial adrenal cysts are uncommon retroperitoneal lesions. In our case, open adrenalectomy was performed and the prognosis was excellent.

Dermoid Cyst of the Parotid Gland: A Rare Entity.

Dermoid cysts of the head and neck are a rare entity. These cysts are benign cystic malformations and histologically composed of tissues originating from ectoderm and mesoderm. Dermoid cysts usually presents as midline neck mass and rarely appear in lateral region. These are extremely rare in parotid gland, however should be considered as a differential in the list of parotid mass. There are a few cases published till date. Superficial parotidectomy is suggested as surgical treatment, however sometimes enucleation is also sufficient. There are only very few case reports published on dermoid cysts in parotid glands. We present a rare case of this entity and the challenges faced in making diagnosis with a short review of the literature.

Skene gland cyst in post puberal girl

Abstract The finding of an interlabial mass in a girl can create doubts in relation to its etiology, its implications and its management. Skene cysts are an unusually rare at any age, but especially in a girl in post-pubertal age as well as in adult women. Because these lesions can simulate other lesions with important clinical implications, careful urological evaluation is required. Several paraurethral glands are described, Skene's glands are the largest and are located on the distal urethral floor. The incidence of Skene cysts is probably much higher than estimated due to a lack of systematic reporting of their finding. We performed a literature evaluation regarding the reporting of Skene cysts in children and adults. We report the case of a voluminous interlabial mass found in a girl in post-puberal age, the characteristic displacement of the urethral meatus confirmed the suspicion of Skene's parauthral cyst. Skene cysts management tends to be conservative when seen in the newborn, while a surgical approach in the young adult is preferable.