Clinical aspects and pathology of cysts of the jaws. 3. Histopathology of the cysts of the jaws. Leucoplakic changes of the epithelial lining of the cysts.
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Jaw Diseases↗
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[Classification of parotid cysts. Differential diagnosis of salivary duct cysts and lymphoepithelial cysts].
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Adolescent↗
Giant cysts and cysts with multiple central bodies in Azotobacter vinelandii.
Cyst germination in Azotobacter vinelandii ATCC 12837 was studied by using phase contrast and electron microscopy. Germination in this organism was accompanied by the formation of large cyst forms of two different types: giant cysts and cysts containing multiple central bodies. Previously, these two types have been reported only when yeast extract was added to the encystment medium. In this study, we observed giant cysts and cysts with multiple central bodies in nitrogen-free liquid medium. The germination of "normal" cysts is often preceded by enlargement to the giant form and division of the central body to produce cysts with multiple central bodies. Structures similar in appearance to ribosomal aggregates were observed only in cysts undergoing pregermination transformations.
Alcohols↗
Simple renal cysts in hypertensive patients: relation between cyst growing and anti-hypertensive therapy.
The study investigates relationship between simple renal cyst enlargement studied by ultrasonography and anti-hypertensive treatment. To this purpose we enrolled 42 patients with newly diagnosed hypertension affected by simple renal cysts. Fourteen were randomly assigned to treatment with ACE-Inhibitors (group 1), twelve to diuretics (group 2) and sixteen to Ca-Antagonists (group 3). Patient performed a basal ultrasonography to evaluate basal cyst dimension before starting anti-hypertensive treatment. Following 12 months of the anti-hypertensive regimen, a new echograph was performed to evaluate changes in cyst size. A control group consisting of 15 patients with normal blood pressure and simple renal cysts was enrolled (group 0). An enlargement of cysts was detected in all patients. However, the enlargement observed in patients treated by Ca-Antagonists was significantly greater than that observed in the other groups (p<0.05). Our study supports the hypothesis that Ca-Antagonists may favor cyst enlargement by enhancing cyclic AMP production. In fact, cAMP and cAMP agonists stimulate fluid secretion by lining cells of the cyst wall, inducing cyst enlargement.
Aged↗
Differential scanning calorimetry studies on the cysts of the potato-cyst nematode Globodera rostochiensis during freezing and melting
Differential scanning calorimetry (DSC) was used to determine the thermal events associated with freezing and melting of the cysts of the potato-cyst nematode Globodera rostochiensis. There were no thermal events during the cooling of dry cysts from 5 to -60 °C and warming back to 5 °C, indicating the absence of water freezing in the dry cysts. During heating of dry cysts from 5 to 80 °C, two overlapping endothermic events were observed at 55 °C, indicating the irreversible destruction of the permeability barrier of the eggshell by the melting of the lipids which constitute the lipid layer. The first exothermic event (T=-9 °C) during the cooling of hydrated cysts indicates the presence of an ice-nucleating agent. A broad exotherm at -38 °C is due to the freezing of eggs. DSC thus confirms that the eggshell prevents exogenous ice nucleation and allows the eggs to supercool in the presence of external ice. The enthalpy of the egg exotherm increased during hydration of the cysts. The temperature of the egg exotherm was elevated after heating of the sample to 70 °C. This is thought to be due to the loss of trehalose from the eggs following the destruction of the permeability barrier of the eggshell. During melting, three endothermic events were observed. These became merged after the destruction of the permeability barrier of the eggshell by heating, and only two peaks were observed in isolated eggs. The sample is thus considered to consist of three freezable compartments: (1) the water surrounding the cyst, (2) the solution between the cyst wall and the eggs and (3) the egg contents.
Journal Article↗
Detection of antigenic cyst wall elements in Colpoda inflata: an immunoelectron microscopic study and immunoblotting identification of cyst wall polypeptides.
By using an antiserum against isolated cyst walls from resting cysts of the ciliate Colpoda inflata, cyst wall polypeptides have been identified by immunoblotting test. Likewise, an immunoelectron microscopical study on both complete resting cysts and isolated cyst walls to localize the cyst wall proteins recognized by the antiserum, has been carried out. The immunoblotting test showed that three main polypeptide bands were recognized by the antiserum, with tentative molecular weights of 61, 66 and 70 kDa respectively. This methodology provides a better identification of cyst wall proteins after electrophoretic separation of cyst wall samples from ciliate resting cysts.
Animals↗
GCDFP-70 protein in cyst fluid identified as albumin and used to classify cysts in women with breast gross cystic disease.
We used sodium dodecyl sulfate-polyacrylamide gel electrophoresis to study cyst fluids from women with breast gross cystic disease. The subjects could be classified into two categories according to the concentrations of protein GCDFP-70 in the cyst fluid: those with Type I cysts had a very low content of this protein; those with Type II cysts had very high concentrations. Analysis of the amino acid sequence of GCDFP-70 from both cyst fluid types confirmed that this protein is human plasma albumin. The average concentration of albumin found in Type I cyst fluids was 0.32 g/L and that corresponding to Type II was 10.16 g/L. Thus, albumin quantification from cyst fluids or analysis by either polyacrylamide or agarose gel electrophoresis provides a simple procedure for classifying these fluids, yielding results that correlate well with previous classifications based on other measurements such as sodium, potassium, and chloride concentrations. This albumin-based quantification method may improve the classification of breast cysts and might be useful in further studies on functional changes in the cysts and their relationship to breast cancer.
Adult↗
[Light and electron microscopic studies on cysts of Sarcocystis fusiformis in the muscles of calves infected experimentally with oocytes and sporocysts of the large form of Isospora bigemina from dogs. 2. The fine structure of cyst stages].
In several experiments calves were infected with sporocytes of the large form of Isospora bigemina from dogs thus producing "thin-walled" cysts of Sarcocystis fusiformis in muscles. Following the growth of the cyst the development of the cyst stages (metrocytes, merozoites) was studied by electron microscopy. Cyst formation began about 34 days p.i. from a parasitophorus vacuole containing exclusively ovoid metrocytes. One the 62nd day p.i. mainly metrocytes and a few banana-shaped stages were present in the cysts. These banana-shaped stages were called merozoites, because we consider the process of cyst formation as an extraintestinal schizogony. From the 76th day p.i. mainly merozoites, i.e. infectious stages, were observed. The metrocytes were surrounded directly by the amorphous ground substance of the cyst's interior, whereas the merozoites were closely packed within chamber-like hollows of the ground substance. The metrocytes are globular cells, about 7 X 5 mum. These cells possess as the metrocytes of other species a typical three-layered pellicle with deep micropores, a conoid, polar ring with 22 anchored subpellicular microtubules, very few rhoptries and micronemes, a golgi complex anterior to the large nucleus. The nucleus has a spherical nucleolus consisting of granular and fibrillar zones. Chromosomal structures were seen in two different stages: large dense plaques (condensed stage), and as small dense granules of 300-400 A diameter, arranged spherically within the karyoplasm (extended stage). There is no significant difference in fine structure between the metrocytes of I. hominis-induced cysts and those from cysts after infections with the large form of I. bigemina from dog.
Animals↗
Immunohistochemical study of bcl-2 protein, Ki-67 antigen and p53 protein in epithelium of glandular odontogenic cysts and dentigerous cysts.
The aim of the present study was the evaluation of the immunohistochemical expression of the apoptosis-inhibiting protein bcl-2, the cell-cycle-related antigen Ki-67 and the p53 protein, which is involved both in cell cycle and apoptosis regulation, in the lining epithelium of glandular odontogenic cysts of the jaws. Formalin-fixed and paraffin-embedded tissue sections of three glandular odontogenic cysts and six dentigerous cysts were immunostained with a standard avidin-biotin peroxidase procedure, after microwave antigen retrieval. The glandular odontogenic cysts showed immunoreactivity for bcl-2 protein in the basal and suprabasal layers, while staining in dentigerous cysts was basal or focal. Most mucous cells and superficial cuboidal cells were negative. The percentage of Ki-67- or p53-positive cells was lower in glandular odontogenic cysts compared with dentigerous cysts. The findings suggest that the biological behavior of glandular odontogenic cysts may be associated with deregulation of cell death in the lining epithelium, while cell proliferation and p53 status do not seem to play a significant role.
Adolescent↗
Paraesophageal bronchogenic cyst associated with multiple epithelial splenic cysts.
BACKGROUND: Bronchogenic cysts are rare congenital cystic lesions of foregut origin. They are the result of abnormal budding of the primitive tracheobronchial tube. Nonparasitic, true splenic cysts are another rare entity that might occur as incidental findings but may lead to deleterious courses in case of ruptures. CASE REPORT: We report here the first case of the uncommon association of a paraesophageal bronchogenic cyst and multiple primary splenic cysts in a 23-year-old woman suffering from dysphagia and chest pain. Successful complete resection of the paraesophageal cyst was performed using an abdominal, transhiatal approach and splenic cysts were subjected to organ-preserving TA stapler resection. CONCLUSION: Thus far there is no proof or genetic indication for a direct association of bronchogenic cysts and multiple splenic cysts, however, the uncommon coincidence of both lesions in our patient might suggest a common origin. Difficulties in preoperative diagnosis, histopathological characteristics and surgical treatment modalities are presented.
Adult↗
Epithelial (true) splenic cysts. Pathogenesis of the mesothelial and so-called epidermoid cyst of the spleen.
Nonparasitic cysts of the spleen are classified as primary or epithelial cysts if their inner surface has a cellular lining. Depending upon the pattern of the inner surface cell layer, the primary splenic cysts are divided into mesothelial or epidermoid subtypes. In order to study their pathogenesis, five epithelial splenic cysts (two with mesothelial lining, and three with foci of stratified squamous epithelium) were investigated by scanning and transmission electron microscopy and by immunohistochemistry. In places, the squamous epithelium was continuous with a flattened mesothelial layer. Furthermore, within the stratified epithelium, a continuous spectrum of cytodifferentiation from mesothelial to squamous cells was found. Thus, the epidermoid splenic cyst seems to be a variant of the mesothelial cyst with focal squamous metaplasia. Rupture of the splenic capsule with hemosiderin deposits and infoliation of the mesothelium was seen in one case, implying a traumatic genesis. In addition, stoma-like channels providing connections between the lumen of the cyst and the sinus of the adjacent splenic tissue were detected by scanning electron microscopy. As with other cystic lesions, the influx of blood cells and proteinaceous fluid from these stomata may contribute to the growth of the cysts, which are usually of considerable size when surgically removed.
Cysts↗
Lymphoepithelial cyst and epidermoid cyst of the accessory spleen in the pancreas.
We report here two rare cystic lesions, a lymphoepithelial cyst (LEC) and an epidermoid cyst of the accessory spleen (ECAS) occurring in the pancreas. Histologically, the LEC was lined by stratified squamous epithelium and surrounded by a layer of lymphoid tissue with germinal centers. The ECAS showed similar histologic features with scattered lymphoid tissue, but splenic pulp tissue was present in the wall. In both cysts, some small pancreatic islets and ducts were seen in the fibrous tissue surrounding the lymphoid layer or the splenic pulp, respectively. The lining epithelia of the LEC and the ECAS, as well as those of retention cysts of the pancreas and epidermoid cysts of the spleen used for comparison, were similarly positive with AE1/3, CAM5.2, CK7, CK13, and carcinoembryonic antigen. CA19-9 was also detected in the epithelial cells of the LEC, the ECAS, and the retention cyst of the pancreas, but not in those of the splenic epidermoid or branchial cleft cysts used for comparison. These findings indicate that LECs and ECASs might develop from the pancreatic ducts protruding into a lymph node or accessory spleen located in the pancreas, respectively. Some of both cysts might cause elevated levels of serum carcinoembryonic antigen and/or CA19-9 and should be distinguished from malignant cystic tumors.
Aged↗
Surgical experience with nonparasitic cysts of the liver--the characteristics and constituents of cyst fluid.
Fifteen patients with nonparasitic hepatic cysts underwent surgery to relieve abdominal complaints, at the First Surgical Department, Tokyo University Hospital between 1966 and 1989. Total removal of the cyst was carried out in 14 of the patients, while puncture and aspiration only were performed in the other patient in whom a cyst had ruptured spontaneously, after which hemoperitoneum was observed at emergency laparotomy. The size of the cysts varied from 7-19 cm with a mean of 12.4 cm. Histological study revealed a congenital cyst in 14 patients and a cystadenoma in one. The epithelium lining of the internal surface of the congenital cysts was highly atrophic and desolated and often disappeared. Examination of the cyst fluid revealed the same concentration of electrolytes as in the serum. Hepatic enzyme levels were usually lower than in the serum, but lactic dehydrogenase and aminotransferase levels were elevated in a few cases. Tumor marker levels of the cyst fluid were higher than those in the serum in four of five patients examined.
Adult↗
Bilateral symmetrical cysts in the upper tibiae in a skeletally mature patient: might they be simple bone cysts?
A 55-year-old Japanese woman presented with right knee pain of 1-month duration. Radiological studies revealed bilateral mild osteoarthritic changes in the medial knee joint compartment and symmetrical cysts in the upper tibial metaphyses, extending to the epiphyses. Intraosseous ganglion was considered the most probable diagnosis. However, intraoperatively, serous fluid-filled cavities were recognized; these were curetted and filled with hydroxyapatite granules. Histopathological examination of the cyst wall revealed thin fibrous tissue formed of collagen fibers without a lining cell layer, with scattered lymphocytes, histiocytes, irregular masses of fibrin-like material, and periosteal osteocartilagenous callus formation; a picture compatible with simple bone cysts. Bilateral symmetrical cysts of the upper tibial metaphyses extending to the epiphyses are extremely rare. A literature review revealed that the age incidence, and bony locations of multiple and epiphyseal simple bone cysts are atypical in relation to the classic metaphyseal simple bone cysts. Also, multiple and epiphyseal simple bone cysts have a better prognosis than the classic metaphyseal ones. Four clinicoanatomic varieties of simple bone cysts are recognized; classic metaphyseal, nontubular, epiphyseal, and multiple.
Bone Cysts↗
Laparoscopic-assisted total cyst excision of choledochal cyst and Roux-en-Y hepatoenterostomy.
PURPOSE: The aim of this study was to describe the technical experience and outcome in laparoscopic-assisted total cyst excision of choledochal cyst with Roux-en-Y hepatoenterostomy. METHODS: Thirty-five patients with choledochal cyst were studied. Their age ranged from 3 months to 9 years (average age, 3.6 years). The choledochal cysts were cyst type in 33 cases and fusiform type in the other 2 cases. Four trocars were utilized with 3- to 5-mm instrumentation. Under laparoscopic guidance, the gallbladder and the dilated bile duct were excised completely. The Roux-en-Y jejunojejunostomy was performed extracorporeally by exteriorizing the jejunum through the extending umbilical incision (1.5 to 2 cm), and an end-to-side hepaticojejunostomy was carried out intracorporeally by the hand suture methods. RESULTS: Average duration of operation was 4.3 hours (range, 3.5 to 7.6 hours), intraoperative blood loss was 5 to 10 mL, and 8 of the 35 patients had associated hepatic ductal stenosis and underwent laparoscopic excision of the cyst and ductoplasty. In 1 of the 8 cases, bile leak was noticed from day 1 through 26 postoperatively. The postoperative course was uneventful in the other 34 patients with a hospital postoperative stay ranging from 3 to 6 days. There were no postoperative complications in the 3-month to 1(1/2)-year follow-up. CONCLUSIONS: Laparoscopic-assisted total cyst excision with Roux-en-Y hepatoenterostomy is feasible for the treatment of choledochal cyst in children.
Anastomosis, Roux-en-Y↗
Chemical assay of iron in ovarian cysts: a new diagnostic method to evaluate endometriotic cysts.
CA-125 is abundantly secreted from ovarian endometriotic cysts, but is not specific to endometriosis. In order to develop a new, more specific diagnostic marker for endometriosis, the iron concentrations in various ovarian cysts were assayed. The ovarian cysts were punctured and the contents aspirated laparoscopically, laparotomically, or transvaginally. The iron concentration in the ovarian cystic fluid was assayed using a spectrophotometer after protein precipitations and chromogen treatment. The iron concentrations in ovarian cysts were 69.5+/-10.4 micromol/l in serous cystadenomas, 73.5+/-29.3 in mucinous cystadenomas, 65.4+/-12.4 in dermoid cysts, and 92.5+/-18.2 micromol/l in adenocarcinomas. On the other hand, high iron concentrations were demonstrated in endometriotic cysts (1,749.6+/-41.5 micromol/l), a lutein cyst (1,393.8), hemorrhagic corpus luteum (1,957.5) and endometrioid adenocarcinomas (1,860.9+/-157.9 micromol/l). Cytological smear tests of the contents as well as histological examination allowed differential diagnosis between endometriosis and endometrioid adenocarcinoma. In conclusion, assay of the ovarian cystic iron concentration is a useful diagnostic tool for the evaluation of ovarian endometriotic cysts.
Adult↗
Case report of a pigmented dentigerous cyst and a review of the literature on pigmented odontogenic cysts.
This paper reports the first case of a dentigerous cyst containing melanin-pigment and melanocytes in the lining epithelium, and the first case of a odontogenic cyst with macroscopically visible pigmentation in the cyst wall. The patient was a 29-year-old Japanese male with a cystic lesion in the left retromolar area of the mandible. Pathologic examination revealed the lesion to be a dentigerous cyst with or without mild surface keratinization, and numerous granules of melanin-pigment were distributed in the basal cells of the epithelial lining. Furthermore, dendritic melanocytes were scattered in the basal layer. Review of the literature revealed that pigmented odontogenic cysts are uncommon, and only 11 cases have been documented; eight were odontogenic keratocyst, one was a gingival cyst, one was a botryoid odontogenic cyst, and one was a lateral periodontal cyst. The possible origin of melanocytes in odontogenic lesions is discussed.
Adult↗
Ovarian cyst fenestration via the laparoscope. A laparoscopic method for treatment of non-neoplastic ovarian cysts.
A laparoscopic method of managing macroscopically benign, unilateral, unilocular, mobile, translucent, and smooth-walled ovarian cysts in women of reproductive age is described. The method requires the cutting of a window in the cyst wall through the laparoscope fenestration. In preference to aspiration at laparoscopy or removal at laparotomy, this method has the advantage of ensuring histologic material as well as permanent drainage by the use of atraumatic surgical technique. Nineteen cysts were fenestrated laparoscopically. Four cysts could not be classified, two owing to lack of histologic material, two owing to malpreparation of the selected cyst tissue. In one case an epithelial cyst--a mucinous cystadenoma, being laparoscopically unsuspected--was fenestrated. One cyst recurred. By observing the above criteria it is possible and tolerably safe to select non-neoplastic cysts, for which fenestration should be reserved.
Adult↗