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At least 55 records · Page 3Linked to original sources
PubMed1981

Cyst fluid antibiotic concentrations in polycystic kidney disease: differences between proximal and distal cysts.

The concentrations of several antibiotics were measured in the cyst fluid of six adult patients with polycystic kidney disease. Seventy-nine cysts were aspirated at surgery or autopsy. Sixty-one cysts could be categorized as arising from the proximal nephron and 16 from the distal nephron by cyst fluid to serum sodium ratios. Serum, urine, and cyst fluid were simultaneously analyzed for sodium, creatinine, and various antibiotics. Gentamicin, tobramycin, cephapirin, and ticarcillin were either undetectable or present in low concentrations in renal cysts. Cyst fluid antibiotic concentrations did not correlate with cyst volume or creatinine clearance. Cysts of proximal nephron origin had higher antibiotic concentrations than distal cysts. In one patient with normal renal function, inulin was undetectable in renal cysts after a continuous 36-hour i.v. infusion. Para-aminohippurate, however, was detected in the renal cysts of this patient. These data help explain the poor clinical response of infected renal cysts to antibiotic therapy. They also suggest that antibiotics and other solutes may enter cyst fluid across tubular cells in addition to entry by glomerular filtration.

Anti-Bacterial Agents↗
PubMed1992

Cyst fluid from human autosomal dominant polycystic kidneys promotes cyst formation and expansion by renal epithelial cells in vitro.

Autosomal dominant polycystic kidney disease (ADPKD) is characterized by progressive renal enlargement, culminating in renal insufficiency in over one half of affected individuals. The highly variable onset and clinical course of ADPKD may be due to factors extrinsic to the genetically defined renal cysts. In this study, cyst fluid samples from 12 nonazotemic and 18 azotemic ADPKD subjects were examined for in vitro biologic activity that promotes cellular proliferation and the secretion of fluid by renal epithelial monolayers, two pathogenetic mechanisms that have critical roles in the formation and the rate of expansion of renal cysts. Cyst fluid added to culture medium (final concentrations, 1 to 20%) caused Madin-Darby canine kidney cells and human kidney cortex (HKC) cells derived from primary cultures to form cysts in Type I collagen matrix. Cyst fluid stimulated the net transepithelial secretion of fluid by polarized monolayers composed of these same cells. Absolute levels of fluid secretory activity determined by MDCK bioassay were correlated directly with the rate of fluid secretion by HKC cell monolayers and with the extent of cyst formation by MDCK and HKC cells embedded in collagen matrix. The secretory activity of urine was negligible; secretory activity was detectable in the serum of normal and ADPKD subjects, but the levels were much lower than in cyst fluid. cAMP agonists prostaglandins E1 and E2, arginine vasopressin, and 8-Br-cAMP stimulated fluid secretion by MDCK and HKC monolayers, but these substances did not cause HKC cells to form cysts in collagen matrix, whereas cyst fluid did. Among other naturally occurring growth factors and autacoids, only epidermal growth factor and transforming growth factor alpha stimulated cyst formation by HKC cells; however, the capacity of cyst fluid to stimulate fluid secretion was not affected by treatment with antiserum to epidermal growth factor. It was concluded that potent, and possibly unique, substances in the cyst fluids of individuals with ADPKD support and augment biologic processes in renal epithelial cells that may be important in the promotion of progressive cyst expansion.

8-Bromo Cyclic Adenosine Monophosphate↗
PubMed1992

CA 125 concentrations in ovarian 'chocolate' cyst fluid can differentiate an endometriotic cyst from a cystic corpus luteum.

In a prospective study, the concentrations of CA 125, 17 beta-oestradiol and progesterone were assayed in 52 consecutive ovarian cysts, laparoscopically suspected to be endometriomas. Cysts with dark brown 'chocolate' fluid (n = 42) were excised by CO2-laser endoscopy. Cysts with clear fluid were diagnosed by pathology as follicular cysts (n = 5) or pseudoperitoneal cysts (n = 5). Fluids (n = 53) aspirated during echo-guided puncture for in-vitro fertilization (IVF) were assayed simultaneously. Of the 42 women undergoing a cystectomy, the clinical diagnosis of an endometrioma was confirmed by pathology in only 68%, the other cases being corpora lutea (27%) or follicular cysts (5%). Cyst fluids from corpora lutea had lower CA 125 concentrations (< 1000 IU/ml) together with high 17 beta-oestradiol concentrations (> 2000 pg/ml) and/or high progesterone concentrations (> 100 ng/ml). Endometriotic cysts had either very high CA 125 concentrations (> 10,000 IU/ml) as occurred in 78% or lower CA 125 concentrations (< 1000 IU/ml) together with low 17 beta-oestradiol and/or progesterone concentrations. 'Chocolate' fluid-containing cysts aspirated during IVF had similar concentration profiles of CA 125, 17 beta-oestradiol and progesterone and the diagnoses derived from these concentrations were not contradicted in 19/27 women undergoing a laparoscopy within 4 months. In eight women, however, with high CA 125 concentrations in their cyst fluid, no endometriotic cysts were found at laparoscopy. Only 68% of cysts containing 'chocolate' material were endometriotic cysts and CA 125 could be useful in making this diagnosis. This method is recommended when dark brown fluid is aspirated in IVF.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed2003

[Flair and diffusion weighted MR imaging in differentiating epidermoid cysts from arachnoid cysts].

PURPOSE: To explore the use of fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted echo planar imaging sequences in imaging of the intracranial epidermoid and arachnoid cysts and assess the efficiency of those sequences in differentiation of epidermoid cysts from arachnoid cysts. MATERIALS AND METHODS: This study was performed prospectively by using two different MR devices in 24 patients (12 epidermoid cysts, 12 arachnoid cysts). T1-weighted spin echo, T2-weighted fast spin echo, FLAIR and diffusion-weighted echo planar imaging sequences were used. Lesions were evaluated qualitatively and quantitatively. In qualitative evaluation, the signal intensity of the lesions were compared with cerebral spinal flow. Quantitative evaluation was made from the diffusion-weighted images by measuring values of apparent diffusion coefficient (ADC) from the cystic spaces and cerebral white matters. In statistic analyses, Mann-Whitney U test was used. RESULTS: Arachnoid cysts had the same intensity with cerebral spinal flow in all sequences. Mean ADC value was 3.41 +/- 0.17 x 10(-3) mm2/sn. All epidermoid cysts on diffusion-weighted trace images were more hyperintense than brain parenchyma. The mean ADC value of the epidermoid cysts was 1.15 +/- 10(-3) mm2/sn. The ADC values of the epidermoid cysts were lower than the arachnoid cysts (p < 0.001), but were higher than the cerebral white matter (p < 0.01). CONCLUSION: FLAIR sequences were superior to conventional sequences in imaging of epidermoid cysts and in differentiation of epidermoid cysts from arachnoid cysts. It was also shown that diffusion-weighted trace imaging and measurement of ADC values might be used as problem solving tools. Furthermore, those sequences may be a guide to demonstrate postoperative residual lesions.

Adolescent↗
PubMed1999

Bile duct cancer developed after cyst excision for choledochal cyst.

Oncogenesis after cyst excision for choledochal cyst and suitable surgical procedures for this operation are discussed. The clinical data of 23 patients with cancer of the biliary tree after excision of choledochal cyst reported in the English-language and Japanese literature were reviewed, and data for 1353 Japanese patients with choledochal cyst and/or pancreaticobiliary malunion were analyzed. In the 23 patients reported in the literature, age at cyst excision ranged from 1 to 55 years (average, 23.0 +/- 13.7 years), and cancers were detected at age 18-60 years (average, 32.1 +/- 12.2 years), with intervals between cyst excision and cancer detection of 1-19 years (average, 9.0 +/- 5.5 years). Sites of cancer development were: intrahepatic, six; anastomotic, eight; hepatic side residual cyst, three; and the intrapancreatic duct, six. In the Japanese patients with choledochal cyst and/or pancreaticobiliary malunion, the incidence of cancer associated with primary choledochal cyst and/or pancreaticobiliary malunion was 16.2% (219/1353). The incidence of cancer development after cyst excision in this population, of whom 1291/1353 underwent surgery, was assumed to be 0. 7%. Nearly half of the 23 patients in the literature had undergone inadequate cyst excision. Oncogenesis of cancers after cyst excision is possibly different from that of choledochal cysts.

Adolescent↗
PubMed1999

Eruption speed and rate of angulation change of a cyst-associated mandibular second premolar after marsupialization of a dentigerous cyst.

The purpose of this study was to investigate the eruption speed and rate of angulation change of a cyst-associated mandibular second premolar after marsupialization of a dentigerous cyst in preadolescents. Premolars on the cyst and noncyst sides and size of the cyst were retrospectively examined with a total of 42 pairs of normalized panoramic radiographs in 20 patients who underwent neither extraction nor orthodontic traction of the cyst-associated mandibular second premolar after marsupialization. Sixteen premolars at the intraosseous eruption stage in a total of 9 preadolescents without cysts were also examined. The eruption speed and rate of angulation change of the cyst-associated mandibular second premolar were significantly faster than those of the premolars without cysts, and significantly correlated with the diminishing rate of the cyst size, which rapidly decreased for the first 3 months after marsupialization. In addition, the eruption speed of the cyst-associated mandibular second premolar correlated with that of the premolar on the noncyst side, and the rate of angulation change inversely correlated with the level of root formation. The results suggest that a cyst-associated permanent tooth erupts more rapidly regardless of the level of root formation and size and type of the cyst, and the abnormally tilted tooth axis improves more rapidly for the first three months after marsupialization of a dentigerous cyst in preadolescents.

Bicuspid↗
PubMed1995

Cervical thymic cysts: CT appearance of two cases including a persistent thymopharyngeal duct cyst.

The differential diagnosis of cervical cysts in children includes common entities such as branchial cleft cysts, thyroglossal duct cysts, and cystic hygromas. Congenital thymic cysts are uncommon and often misdiagnosed as either branchial cleft cysts or cystic hygromas. However, they may have an appearance on CT that can be characteristic. The course of the descent of embryologic thymic tissue in the neck to the mediastinum indicates the potential site of deposition of an ectopic cervical thymic cyst. In a child, a cystic lesion that has an intimate relationship to the carotid sheath is likely to be a thymic cyst. Of the approximately 100 cases of vestigial cervical thymus or thymic cysts that have been reported in children, only 5 cases of a persistent thymopharyngeal duct cyst have been described [1-5]. In two of these five, the persistent thymopharyngeal duct cyst was demonstrated by CT [1,2]. We report one additional case of a cervical thymic cyst and one case of a persistent thymopharyngeal duct cyst both depicted by CT.

Child, Preschool↗
PubMed2005

"Disc cysts" and "posterior longitudinal ligament ganglion cysts": synonymous entities? Report of three cases and literature review.

OBJECTIVE AND IMPORTANCE: Extradural cysts intimately associated with relatively normal lumbar discs have rarely been reported. Histologically nonspecific, most have been designated posterior longitudinal ligament (PLL) or annulus fibrosus (AF) "ganglion cysts." Recently, "disc cysts" have been distinguished as a separate entity, mostly on the grounds of cyst-disc communication. CLINICAL PRESENTATION: Three young male patients presented with unilateral sciatica. In all cases, magnetic resonance imaging demonstrated rounded, cystic lesions (i.e., hypointense on T1- but hyperintense on T2-weighted scans) adjacent to minimally dehydrated, nonherniated disc spaces. INTERVENTION: At surgery, each cyst was found intimately related to either the AF (Case 3) or the PLL (Cases 1 and 2) of the adjacent disc; and direct disc-space communication was evident in Case 3. After cystectomy, with or without discectomy, all patients achieved complete and long-lasting resolution of their sciatic symptoms. Histological appearances were typical of ganglion cysts in all three cases, with evidence of prior hemorrhage in Cases 1 and 3. CONCLUSION: Our results and those of others suggest that all such cysts are ganglion cysts that derive from either the AF or the PLL at the disc level. Although disc cysts might be AF ganglion cysts exhibiting disc communication, their separate distinction is probably unnecessary. Cystectomy alone affords complete symptomatic remission; discectomy is usually unnecessary. Although anticipated with ganglia in general, neither spontaneous resolution nor postoperative recurrences have been witnessed. Unlike ganglia in general or juxtafacet ganglion cysts, such cysts seem to be unusually restricted to young men.

Adult↗
PubMed1991

[Ultrastructural findings of arachnoid cysts and epithelial cysts].

There may be several kinds of pathological conditions in the cystic lesion which are clinically diagnosed as benign intracranial cysts on CT scan. Light and electron microscopic studies on cyst walls were important in the differential diagnosis of benign intracranial cysts. We have studied 5 cases of intracranial arachnoid cysts and two epithelial cysts using the light and electron microscopy. Five cases of intracranial arachnoid cysts included two children and three adults (three females and two males). Three cases of them were localized in the middle cranial fossa, one case in the anterior and middle cranial fossa and one case in the lateral ventricle, giving headache and convulsion as the initial complaints. As for the epithelial cysts, one was localized at the para-collicular area complaining enlarged head and swollen anterior fontanelle and the other of four years was located in the fourth ventricle with headache and ataxic gait. On CT all of them demonstrated diffuse low density areas in both the arachnoid and the epithelial cysts without communicating findings between the cystic cavities and subarachnoid space on metrizamide CT cisternography. The arachnoid cyst walls were basically similar in structure to the normal arachnoid membrane and composed of elongated epithelial cells like the arachnoid cell and the connective tissues with lamellar collagen fiber bundles. However, 3 of the 5 cases had only fibrous tissues without epithelial cells. The inner sheath of the arachnoid cyst walls was composed of one or several layers of the arachnoid cells with flattened and relatively electron-dense cytoplasm on electron micrograph. They had a lot of elongated process and were tangled with each other, making large extracellular spaces between them. Below the electron dense arachnoid cells, compact packed cells with interdigitation partly demonstrated intercellular contacts such as numerous desmosomes and tight junctions. In those intercellular spaces collagen fibers and microfibrils were observed. The cells contained abundant cytoplasmic microfibrils and numerous organelles. They were separated from numerous collagen fibers and fibroblasts by non continuous basal lamina under the epithelial cells. Epithelial cyst wall had a layer of cuboidal or columnal epithelium in the inner layer of cyst wall. Those epithelial cells demonstrated granules having positive in PAS and mucicarmine stain in their cytoplasm. On electron microscopical study epithelial cells revealed a lot of microvilli and coating materials on the surface of them without cilia. The basement membranes were well developed under the epithelial cells separated from the connective tissues. In the intercellular clefts of the epithelial cells tight junctions and interdigitations were recognized.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1983

Hybrid cyst: a combined epidermoid and trichilemmal cyst.

Seven cases of hybrid cyst, a combined epidermoid and trichilemmal cyst, are reported. Hybrid cysts occurred in five men and two women, and involved the scalp, cheek, back, arm, elbow, and forearm. The clinical diagnosis was usually cyst or sebaceous cyst. Microscopically, the upper portion of the cyst showed epidermoid keratinization in continuity with the surface epidermis, and was indistinguishable from an epidermoid cyst. Showing sharp transition from it, the inferior portion of the lesion displayed trichilemmal keratinization and was indistinguishable from a trichilemmal cyst. Hybrid cyst is not merely a newly described pathologic curiosity; rather, it forms a meaningful link between the two most common types of follicular cysts and adds weight to the body of evidence that most epidermoid cysts are related to the follicular infundibulum, while trichilemmal cysts are related to the follicular isthmus.

Adult↗
PubMed2003

Sonography of fetal choroid plexus cysts: detection depends on cyst size and gestational age.

OBJECTIVE: To establish diagnostic criteria for the diagnosis of fetal choroid plexus cysts across gestation. METHODS: Prenatal sonographic images of 166 fetuses without choroid plexus cysts were prospectively collected from 13 weeks to term. Texture characteristics of the choroid plexus regions were analyzed to quantify changes as a function of gestational age. A set of 20 fetal sonographic images with choroid plexus cysts were used to create cyst prototypes (1.5-2.5 mm), which were randomly embedded into normal choroid plexus images from varying gestational ages. A test set of 544 images was created, which included 408 images with choroid plexus cysts and 136 images without choroid plexus cysts. Four observers following a blinded study design evaluated the presence of choroid plexus cysts in the images. The influence of cyst size and gestational age on the detection of cysts was measured with receiver operating characteristic analysis and analysis of variance. Observer agreement was characterized by agreement kappa statistics. RESULTS: Texture analysis indicated greater echo texture heterogeneity at earlier gestational ages. The receiver operating characteristic analysis showed a corresponding decrease in diagnostic accuracy for cyst detection at earlier gestational ages. The cyst detection threshold (area under the receiver operating characteristic curve, 0.8) was 2.4 mm (SE, 0.2 mm) for 13 to 21 weeks' gestation and decreased to 1.9 mm (SE, 0.17 mm) for 22 to 38 weeks' gestation. Average interobserver and intraobserver kappa statistics were 0.37 and 0.53, respectively. CONCLUSIONS: Because of the changing echo texture of the choroid plexus through gestation, choroid plexus cysts must be at least 2.5 mm in diameter for confident diagnosis before 22 weeks' gestation and at least 2 mm after 22 weeks.

Adult↗
PubMed2000

[A case of female paraurethral cyst diagnosed as epithelial inclusion cyst].

The patient was a 36-year-old woman with a chief complaint of pain of the urethral meatus. A cyst existed just below the urethral meatus. The paraurethral cyst was removed completely. Histologically, the cyst was lined by stratified squamous epithelium. According to the criteria proposed by Das, paraurethral cysts are classified into 4 groups: epithelial inclusion cysts, Müllarian cysts, Gärtner duct cysts, Skene duct cysts. In this case, the cyst seemed to be an epithelial inclusion cyst. In the Japanese literature, paraurethral cysts have been incompletely classified from an etiological perspective. Differential diagnoses based on the histological findings of the cysts may be important to determine the etiology.

Adult↗
PubMed1983

Use of milk progesterone enzyme immunoassay for differential diagnosis of follicular cyst, luteal cyst, and cystic corpus luteum in cows.

In 160 cows with ovarian cysts as determined by rectal palpation, differentiation was made of follicular cyst, luteal cyst, and cystic corpus luteum on the basis of milk progesterone concentrations estimated by an enzyme immunoassay before and at 10 days after cows were treated with gonadotropin-releasing hormone. Cows having a progesterone concentration in skim milk less than 1.0 ng/ml were considered to have follicular cysts and those with concentrations of 1.0 ng/ml or higher were regarded as the cases of luteal cyst or cystic corpus luteum. Luteal cyst was characterized by progesterone values remaining high in the cows for 10 days after treatment, and cystic corpus luteum was characterized by a decrease in progesterone concentration after cows were treated. By the rectal palpation procedure it was impossible to differentiate luteal cyst and cystic corpus luteum from follicular cyst. The frequencies of follicular cyst, luteal cyst, and cystic corpus luteum were 65%, 19%, and 16%, respectively. Of 104 cows with follicular cysts as defined by milk progesterone assay result, 73 (70%) responded to the treatment with gonadotropin-releasing hormone, the milk progesterone concentration increasing from 0.7 +/- 0.2 ng/ml (mean +/- SD) to 1.8 +/- 1.1 ng/ml. The accuracy of rectal palpation 10 days after treatment for judgment of luteinization of follicular cyst confirmed by milk progesterone analysis was only 30% (48 cows of 160).

Animals↗
PubMed1995

[A case of complex brain anomaly with arachnoid cyst treated well by cyst-cisternal shunt].

A rare case of complex anomaly, composed of schizencephaly, polymicrogyria, heterotopic gray matter, agenesis of the septum pellicidi and arachnoid cyst at the right middle cranial fossa was encountered. A 38-year old man, complaining of epileptic seizure, was admitted to our department. His past history included cerebral palsy. Plain skull roentgenogram showed protrusion of the right temporal bone and thinning of the ipsilateral sphenoidal wing. CT revealed arachnoid cyst and parietal crest surrounded by cortical layer on the right side. MRI also demonstrated the arachnoid cyst, parietal crest and agenesis of septum pellicidi. MRI, especially proton density weighted image, well demonstrated cortical layer surrounding the parietal crest, right opercular polymicrogyria and left heterotopic gray matter. The crest was diagnosed as schizencephaly. The arachnoid cyst was treated by cyst-cisternal shunt with a silicone tube (Sapporo shunt) after fenestrating the cyst. The tube was inserted into the sylvian fissure from the cyst and sutured to the inner wall of the cyst. Despite slight intratumoral hemorrhage in the CT at 1.5 months after the operation, the cyst markedly decreased in size. As to the diagnosis of the brain anomaly, MRI gives extremely useful information. Particularly for the diagnosis of anomalies of migration of neuronal cells, MRI, especially proton density weighted image, has been regarded as an indispensable examination. In the operation of subarachnoid cyst, to maintain the flow between the inside of its cyst and the basal cistern, cyst-cisternal shunt with a silicone tube had satisfactory results.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗