Round Cysts Research Articles

Fatty tissue breast lesions

Hamartoma, lipoma and fat necrosis are benign fatty tissue lesions that may present as breast lumps. The mammographic appearance may be distinctive allowing imaging diagnosis without biopsy. The characteristic feature of hamartoma is that of a compressible mass containing radiolucent fat interchanged with dense fibrous connective tissue surrounded by a thin radioopaque pseudocapsule. Lipomas are radiolucent with well-defined thin smooth capsule. Twenty-seven percent of fat necrosis appears as discrete round or oval radiolucent oil cyst with thin capsule and egg-shell calcification.

Multiple intrahepatic biliary cysts in children with biliary atresia

Purpose: The aim of this study was to investigate the incidence, clinical course, and outcome of multiple intrahepatic biliary cysts in patients with biliary atresia. Methods: From 1992 to 2000, 154 patients with biliary atresia were examined for intrahepatic cysts. They were followed and examined routinely using abdominal ultrasonography. Results: Twenty-three patients had single intrahepatic cysts, and 16 patients had multiple cysts. The incidence of intrahepatic cysts in these patients were 25.3% (39 of 154) for all kinds of cysts and 10.4% (16 of 154) for multiple intrahepatic cysts. Of the 16 patients with multiple cysts, 13 (81.3%) had jaundice, and 15 (93.8%) had a history of cholangitis before cysts were detected. Image studies showed multiple discrete ovoid or round intrahepatic biliary cysts with various sizes along the biliary trees. The cysts decreased in size or number in 7 patients after antibiotic treatment and disappeared in only one patient. The mortality rate was higher in patients with multiple cysts than in those with single cysts (P =.037). Conclusions: Multiple intrahepatic biliary cysts are a common complication in patients with biliary atresia and suggests a poor prognosis. Prolonged parenteral antibiotics treatment should be administered when signs of biliary infection appear. J Pediatr Surg 37:1183-1187. Copyright 2002, Elsevier Science (USA). All rights reserved.

HISTOPATHOLOGICAL STUDY OF THE MÜLLERIAN DUCT REMNANT: CLARIFICATION OF DISEASE CATEGORIES AND TERMINOLOGY

We determined by histopathological studies whether there is an etiological difference in 2 distinct categories of müllerian duct remnant diseases. In addition, we clarified the nomenclature of these diseases. We recently performed radical prostatectomy in a patient with prostate cancer associated incidentally with a so-called müllerian duct cyst in the prostatic midline. The specimen was examined by pathological and immunohistochemical testing with special attention to the relationship of the cyst and utricle. We also investigated the histology of so-called enlarged prostatic utricles or vagina masculinus extirpated from patients with severe hypospadias or intersex disorder. The round cyst removed with the prostate seemed to arise from the verumontanum and it contained fluid with a high concentration of prostate specific antigen. Histological and immunohistochemical examination of its lining epithelium demonstrated that cyst characteristics were identical to those of the prostatic utricle. On the other hand, pouches extirpated from patients with pediatric problems were lined by squamous epithelium. The so-called müllerian duct cyst appeared to originate from the prostatic utricle, and so should be termed a utricular cyst or cystic utricle. Conversely the so-called enlarged prostatic utricle should be termed a vagina masculinus or male vagina. The term müllerian duct remnant, which would include these 2 abnormalities, may usefully be replaced by the term utricular abnormalities.

Ovarian sclerosing stromal tumors: gray scale and color Doppler sonographic findings.

Sclerosing stromal tumors are rare benign ovarian stromal tumors, which have distinctive clinical and pathologic features. The tumors occur predominantly in the second and third decades and are histologically characterized by the pseudolobular pattern of the cellular and hypocellular areas, marked vascularity, and heterogeneity of the cellular area. We analyzed 7 cases of sclerosing stromal tumors, which showed a typical sonographic appearance. On sonograms, sclerosing stromal tumors were solid and cystic and contained multiple round or cleftlike cysts. Ascites was rare. On transvaginal color Doppler sonograms, sclerosing stromal tumors were very hypervascular in the peripheral solid area and internal intercystic space and showed low-impedance flow. We conclude that sclerosing stromal tumors should be considered in young women with menstrual irregularity who have hypervascular solid and cystic adnexal masses.

Renal Cyst Pseudoenhancement: Beam-hardening Effects on CT Numbers

To determine if simple renal cysts may be accurately characterized with helical computed tomography (CT) during peak levels of renal enhancement. Water-filled "cysts" were suspended in varying concentrations of iodine solution, meant to simulate varying levels of renal enhancement, within an abdominal phantom. Volume-averaging effects were minimized by scanning cylindric 5-30-mm cysts with a helical technique (collimation, 5 mm; pitch, 1:1). Axial and helical techniques were then compared, and volume-averaging effects were evaluated by scanning 10- and 20-mm round cysts with 3-, 5-, and 7-mm collimation at background attenuation levels of 100 and 200 HU. Cylindric cyst attenuation increased consistently with increasing background attenuation. As background attenuation increased by 90 HU, attenuation increased by 11-17 HU in small (5- or 10-mm) cysts, and by 7-9 HU in large (15-30-mm) cysts. As background attenuation increased by 180 HU, attenuation increased by 18-28 HU in small cysts and by 10-15 HU in large cysts. Spherical cyst attenuation differences were maximized when smaller cysts were imaged with larger collimation, which is when volume-averaging effects became apparent. Axial and helical CT numbers did not differ substantially. Computer simulation studies showed that the observed effect could not be explained by beam hardening alone. Pseudoenhancement of renal cysts may occur if helical CT is performed during peak renal enhancement. CT algorithm modification may be necessary to correct for this effect, which is likely related to an inadequate algorithmic correction for beam hardening.

Amebic Encephalitis Caused by Balamuthia mandrillaris in a Czech Child: Description of the First Case from Europe

We describe a fatal case of amebic encephalitis caused by Balamuthia mandrillaris in a 3-year-old Czech boy who had never traveled abroad. This is the first such infection reported in Europe. The diagnosis was established by brain biopsy, in which abundant trophozoites and a few round amebic cysts were identified. The presence of multiple nucleoli in some trophozoites suggested the organism to be Balamuthia mandrillaris and this was confirmed by indirect immunofluorescence. The amebae invaded brain tissue, including neurons, and blood vessel walls, causing thrombovasculitis. The tissue reaction was a subacute necrotizing and granulomatous encephalitis (GAE) with an infiltrate of CD4- and CD8-positive T-lymphocytes, B-lymphocytes, plasma cells and macrophages. The child, in whom no underlying immunodeficiency was demonstrated, died after 45 days. The mode of infection was not established. Postmortem examination of the brain revealed massive areas of necrosis and microscopic findings like those in the surgical specimen. In vitro isolation of B. mandrillaris was unsuccessful.

Pneumocystis carinii Infection of the Conjunctiva in a Patient with Acquired Immune Deficiency Syndrome

Background: Ocular disease, especially the development of choroidal lesions, is a known extrapulmonary manifestation of Pneumocystis carinii infection in the acquired immune deficiency syndrome (AIDS). To our knowledge, conjunctival involvement due to P. carinii has not been described previously.Methods: The authors describe a 33-year-old homosexual male with AIDS in whom a large placoid, white lesion developed involving the tarsal conjunctiva of the right upper lid. Conjunctival malignancy was suspected and biopsies and swabs were taken. At this time, the patient had been receiving monthly aerosolized pentamidine prophylaxis for 18 months, and there was neither a history of pneumonia nor any clinical signs of disseminated infection due to P. carinii.Results: Histopathologic examination results of the conjunctival biopsy specimen showed a necrotic, frothy tissue surrounded by activated fibroblasts. Within this material, Gomori methenamine silver stains showed numerous round and cup-like cysts of P. carinii, confirming the diagnosis that had already been obtained by an indirect fluorescentantibody stain of a conjunctival smear specimen.Conclusions: The presence of white placoid conjunctival lesions in a patient with AIDS may indicate an infection due to P. carinii. Conjunctival disease due to P. carinii widens the spectrum of AIDS-associated ophthalmic pneumocystosis.

Experimental model of posttraumatic syringomyelia: the role of adhesive arachnoiditis in syrinx formation.

An experimental model was devised to elucidate the role of spinal blockade in posttraumatic syringomyelia. Thirty-eight Japanese White rabbits, each weighing about 3 kg, were used in this study. The animals were divided into four groups: in Group 1, eight animals received traumatic injury only; in Group 2, 12 animals received traumatic injury following injection of 100 mg kaolin suspended in 1 cc normal saline solution into the subarachnoid space at the site of trauma; in Group 3, nine animals received traumatic injury following injection of 200 mg kaolin in 1 cc normal saline solution into the subarachnoid space at the site of trauma; and in Group 4, nine animals without traumatic injury received an injection of 200 mg kaolin in 1 cc normal saline solution into the subarachnoid space. The subjective criteria for syrinx formation were the presence of a definite round cyst having a smooth margin and an upper or lower extension of more than 2 cm from the injured site. Syrinx formation was seen in 12.5% (one of eight rabbits) in Group 1, 41.7% (five of 12 animals) in Group 2, 55.5% (five of nine rabbits) in Group 3 and 0% (none of nine animals) in Group 4 (p < 0.05). There was a tendency for the combined trauma/kaolin injection groups to be more prone to develop a syrinx. In the kaolin injection only group (Group 4), no animal showed a definite cyst or an extending cavity during the experimental period. The results suggest that kaolin enhances the extension of multiple small cavities that have already formed at the time of initial injury. The difference between the frequency of syrinx formation and the time of survival was statistically significant well beyond the 0.05% level. The overall difference, relating to the frequency of syrinx development, group, and duration of survival, was also statistically significant. In summary, subarachnoid block secondary to adhesive arachnoiditis is important in initiating the extension of the syringomyelia cavity.

Arteriovenous Malformation associated with Cyst

The authors present the fifth reported case of arteriovenous malformation (AVM) associated with cyst formation. Among these five cases, computed tomography has demonstrated two types of cyst: round, and slit-like with low density. The three patients with slit-like cysts experienced sudden, severe headache, probably due to hemorrhage. The two patients with round cystic lesions did not have sudden headache, and at surgery the cysts were found to contain a mural nodule. These facts suggest that there may be two different mechanisms of cyst formation in the vicinity of an AVM: hemorrhage (slit-like cysts) and exudation (round cysts).

Congenital giant megaureter

We have seen 21 patients with unilateral congenital giant megaureter. Age ranged from 2 months to 8 years. This condition is characterized by giant focal segmental ureteral dilatation producing an elongated and distorted ureter; distally there may be congenital ureteral stenosis or atresia, or a ureter of approximately normal caliber. They usually have a dysplastic and disorganized muscular coat, lined with a columnar epithelial mucosa rather than the usual transitional epithelium. The associated kidney or moiety was hypoplastic, dysplastic, or the site of comparatively mild hydronephrosis associated with atrophic renal parenchyma. Function and volume of the bladder was normal. Twelve of 21 patients had a duplex collecting system on the affected side. One patient had four pelves and proximal ureters opening into a single lower ureter, which was the site of a giant cyst. One of eight simple giant megaureters was suspected of being associated with a solitary kidney. Depending on whether the giant segmental ureteral dilatation was multiple or single, these cases have presented either with marked protruberance of the mid and lower abdomen, which was distended by transverse elongated cysts, or with a round cyst mass in the lower abdomen. Nineteen patients treated by excision of the giant megaureter and the associated kidney or moiety were free of symptoms postoperatively. One 4-month-old infant with multiple congenital abnormalities and urinary tract infections died soon after operation. Another 4-month-old infant with suspected solitary kidney was treated by ureterostomy and was discharged in a critical condition without follow-up.

Ultrasonic features of multicystic dysplastic kidney: expanded diagnostic criteria.

The ultrasonographic features of multicystic renal dysplasia in 15 patients (14 children, 1 adult) are described with emphasis on differentiating this condition from hydronephrosis. The most useful ultrasonographic criteria for identifying multicystic kidney include: (a) the presence of interfaces between cysts (accurate in 100% of cases); (b) nonmedial location of the largest cyst (100%); (c) absence of an identifiable renal sinus (100%); (d) multiplicity of oval or round cysts that do not communicate (93%); and (e) absence of parenchymal tissue (73%). The role and usefulness of radionuclide renal scanning are also discussed. Ultrasonography followed by nuclear scintigraphy appears to be a logical diagnostic sequence in the evaluation of neonates with flank masses. Excretory urography is of value in assessing the status of the uninvolved kidney.

PATHOLOGICAL STUDIES, INCLUDING MICRODISSECTION, OF RENAL CHANGES IN THE MECKEL SYNDROME

This study is part of a continuing project on the classification of renal cystic disease using both clinical and pathological criteria. In this paper we present pathological studies, including microdissection, of cystic kidneys from 10 patients with a condition which is well defined by clinical and genetic criteria, the Meckel syndrome.The renal cysts were bilateral in 9 patients and unilateral in one. In the bilateral cases, there were numerous cysts up to 1 cm in diameter present in both cortex and medulla, while in the unilateral case cysts were both few in number and small in size (most were less than 1 mm in diameter) and present only in the cortex. Most of the cystic kidneys were markedly enlarged (average 10 times normal weight) and, in all but one of the bilateral cases, the right and left kidneys were of comparable size.Histologically there were reduced numbers of renal corpuscles with many cysts of varying sizes present within a moderately cellular interstitial tissue. Many of the cysts contained intraluminal polypoid projections, similar to the picture presented by the intracanalicular fibroadenoma of the breast.Microdissection displayed rounded cysts which were characteristically localized to the terminal proximal convoluted tubules, and to the crests of the loop of Henle.This combination of renal pathological features is, to the best of our knowledge, diagnostic of the Meckel syndrome.

Cladistic Approaches in the Study of Soil and Plant Parasitic Nematodes

Cladistic analysis of free-living soil nematodes of the Leptonchoidea (Nematoda: Dorylaimida) resulted in groupings different from those obtained by traditional methods. We can interpret distributions of species groups obtained by phyletic analysis in relation to plate tectonic events. Similar techniques are applicable to plant parasitic nematodes. Grouping on the basis of synapomorphies produced a cladogram of genera of the family Heteroderidae (Nematoda: Tylenchida) in which Meloidodera and Cryphodera appear to be the most ancestral genera and the cyst forming genera the most derived. A cladogram of groups of species in Heterodera sensu lato showed a major division, with the round cyst nematodes and the Cacli group in one grouping and the rest of the Heterodera species in the second. I interpret present-day distributions by a strict vicariance view and suggest potential falsifiers; and also discuss ancient dispersal routes as alternative ways of thinking about nematode distribution.

Cuticle Structure in the Genus Heterodera

The cuticle structure of H. rostochiensis males and of the females of fourteen species or pathotypes of Heterodera was examined with light and electron microscopes. The layers of the male cuticle resemble those of the 2nd-stage larva and other vermiform Tylenchida so far described. The cuticle of females differs from this basic pattern in ways that fit their swollen form and sedentary habit, and their ultimate function as a protective cyst enclosing the quiescent eggs. The outer and inner layers, A and B, of males and larvae are supplemented by a third, fibrous layer, C, in lemon-shaped and round-cyst nematodes and by a fourth layer, D, in round-cyst nematodes only. The fibres in D are arranged helicoidally as in the chitin of insect endocuticle. The B layer of larvae and males is crystalloid, with disjunctions in the regular pattern at every half-annule. The periodicity of the pattern is 18-20 nm, similar to one of the forms of collagen. In females, the B layer ruptures as the body swells and ultimately occurs as separate islands at the junction of the A and C layers. Stained sections observed with bright field, phase, polarised light or interference microscopy, suggested that the thick fibre layers C and D are collagenous and that the A and C layers contain lipid. The composition and function of the various layers and the role of collagen are discussed. The differences in cuticle structure between the species with lemon-shaped and round cysts supports placing the round-cyst species (possibly excluding H. punctata) into the separate genus Globodera, already suggested by Skarbilovich as a subgenus.

Observations On the Cyst-Wall Patterns of Four Species of Heterodera

The cyst-wall patterns of three Heterodera-species with lemon-shaped cysts (H. schachtii, H. goettingiana and H. carotae) and one with round cysts (H. rostochiensis) have been studied with the aid of a scanning electron microscope. These four species possess quite distinctive cyst-wall patterns which facilitate their identification.

Potato cyst nematode: 1 species or 2?

THE potato or golden cyst nematode, Heterodera rostochiensis Woll., is an important pest of potatoes and tomatoes but has never been fully described. It belongs to the group of species of Heterodera1,2 which have round cysts and do not produce an egg sac3, for which the sub-generic name Globodera was suggested4. This group includes H. tabacum Lownsbery and Lownsbery, H. virginiae Miller and Gray, H. mexicana Compos Vela, and the undescribed Osborne's cyst nematode, all with host ranges in the Solanaceae. The females of H. rostochiensis turn golden yellow after fertilization; hence the name “golden nematode”. Mean larval lengths2,5,6 range from 450 to 470 µm. In the past, control depended on rotations with infrequent susceptible crops, but recently potato varieties (Maris Piper and Ulster Glade) have been bred with a dominant gene for resistance, derived from Solanum tuberosum ssp. andigena. These resist pathotype A but not pathotype B or E populations of H. rostochiensis7. Guile8,9 showed that pathotype E females remain white until they die and become cysts, whereas pathotype B females, which produce few cysts on H. multidissectum (Hawkes), have a prolonged cream and a very short yellow phase. Webley10 showed that larvae of pathotypes B and E were longer, and had longer stylets and a greater distance between the crescentic valves of the median pharyngeal bulb and the excretory pore than larvae of pathotype A.

An Apparatus for Separating Round Cysts of the Genus Heterodera, from Dry Float Debris

SUMMARYCysts of the potato cyst nematode, Heterodera rostochiensis, were separated from dry float debris by rolling the mixture down the inside of a specially constructed revolving metal cylinder. From 4⋅2 g of dry float, 85 per cent of the cysts, containing 91 per cent of the larvae, were recovered free from debris.

On epithelial formation after homologus subcutaneous transplantation of urinary bladder and skin.

SUMMARYUrinary bladders from fully developed fetuses of rabbit and slips of skin from newborn rabbits, aged 6 hours, were placed in a 1 per cent trypan blue solution from George T. Gurr (No. 06186) for about 24 hours in ordinary room temperature. They were then transferred to the hypodermis of grown‐up rabbit males. The transplants and their surroundings were microscopically examined after 14 days (the urinary‐bladders) and 21 days (the skin). The control material consisted of an identical number of transplantations of the same organ without any foregoing staining (called “direct” transfers).Healthy transitional epithelium round cysts of a varying size appeared in the trypan blue group at a frequency so markedly higher that the conclusion is drawn that trypan blue treatment causes a prolongation of the survival time of that epithelium.Epithelium of an epidermal character appeared definitely in 4 cases of skin transfer after trypan blue treatment, but in no instance among the controls (18 transfers in each group).It is stated as probable that the epithelium that was found had been formed through proliferation from regenerative centres within the transferred epithelium, while the epithelium otherwise has been lost. Possibly, the trypan blue treatment, it is also suggested, has increased the vitality in the regenerative centres.Before work on the above lines is continued, it is, however, indispensable to try to find the answers to some other questions regarding the mechanism of the trypan blue treatment, as propounded in the introduction.

MUCOCELE OF THE APPENDIX.WITH REPORT OF A CASE POSSIBLY CARCINOMATOUS IN NATURE.

The somewhat indefinite term mucocele may be retained because it sufficiently suggests the general characters of a condition, the exact nature of which is probably not always the same. In some cases the pathology seems clear; in others there is much uncertainty as to the process of formation; but in all there is a cyst-like appendix with mucoid contents. Such cysts, and in fact all kinds of cysts, of the appendix are comparatively rare. According to Kelly and Hurdon, Ribbert found sixcases among 400 autopsies; Bryant, one case among 124 autopsies; Steiner, three among 2,286; Bordy, one among 528, and they themselves found sixteen cases recorded among 3,770 autopsies at the Boston City Hospital. I have seen but one well-defined case, that herewith reported, among about 2,000 autopsies. The appearance of the diseased appendix is that of a rounded or pyriform cyst with a more or less definite constriction of

On the Psorospekmia and Gregarinæ

ABSTRACT The Psorospermia are microscopical corpuscles of a peculiar kind, which may be generally characterized, in the full-grown condition, as rounded organisms, having a sharply-defined outline, with or without a tail-like appendage. They are flattened and lenticular in figure, and one pole is usually acuminute; and towards this pole several internal vesicles converge in a symmetrical manner. These creatures were discovered by Joh. Miiller in 1841 (Mull. Arch., 1841, p. 477). He found in a young Pike minute round cysts in the cellular tissue of the muscles of the eye, in the substance of the sclerotica, and between this and the choroid coat. The contents of the cysts was a whitish substance, which, when examined microscopically, was found to consist of peculiar elements—the “ Psorospermia.” [A detailed notice of these observations is given in the ‘ Microscop. Journal,’ vol. ii. p. 123, and in the ‘ Brit, and Foreign Med. Rev.,’ January, 1842.] In the following year the same observer (Müller’s Arch., 1842, p. 193) discovered parasitic corpuscles in the swimming bladder of a Gadus callarius, which, although specifically distinct from the Psorospermia, approached very near the latter in their organization. They resembled in general a smooth ventricose Navicula, and consisted of two elongated cases applied to each other at the cavity, and with an elliptical outline and convex outer surface. They were in part free, in part enclosed in masses within a tunic. Similar cysts, containing “ Psorospermia,” have been found by Leydig in several species of fish, and in all parts nearly of their bodies, and even in the blood contained in the heart (p. 223), and in the peritoneal cavity.