Eruptive vellus hair cysts. A follicular cyst of the sebaceous duct (sometimes)
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Eruptive vellus hair cysts. A follicular cyst of the sebaceous duct (sometimes)
The eruptive vellus hair cyst is an uncommon, yet distinct, clinical and pathological entity that may be acquired in a sporadic or hereditary form. This descriptive term gives no indication of the type of epithelium lining this cyst. A case report of eruptive vellus hair cyst is reported herein in which the epithelial lining differentiated toward the sebaceous duct. We propose that eruptive vellus hair cysts should be more accurately diagnosed by characterizing the type of epithelial lining.
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[Possible relations between root cysts and follicular cysts in the mixed dentition].
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Effect of gonadotropin-releasing hormone and human chorionic gonadotropin on cows with ovarian follicular cysts.
Ovarian follicular cysts of cattle were defined as follicular structures (larger than or equal to 2.5 cm, diameter) which persisted for 10 days or longer in the absence of functional luteal tissue. Thirty dairy cows with ovarian follicular cysts were allotted to 6 groups (5 cows per group) and each was given 0 (saline solution), 25, 50, 100, 150, or 250 mug of gonadotropin-releasing hormone (GnRH) by intramuscular (IM) injection. Samples of blood were collected before GnRH was injected (0 hour), at 0.25, 0.50, 0.75, 1, 2, 3, and 4 hours, and at 1, 7, 11, 15, and 20 days after treatment. Five additional cows with follicular cysts were treated IM with 10,000 units of human chorionic gonadotropin (HCG), and blood sample collections were made before treatment (0 hour) and on days 1, 7, 11, 15, and 20 after treatment. Serum luteinizing hormone (LH) concentration was not altered in cows given saline solution, but was increased significantly in cows given any of the doses of GnRH (in a dose-related manner). Peak LH responses occurred about 2 hours after GnRH was given, and by 4 hours LH was beginning to decrease. Serum progesterone concentrations increased by more than 2.0 ng/ml by day 11 after treatment in 18 of 20 cows treated with 50, 100, 150, or 250 mug of GnRH. Progesterone responses in these cows were greater (P less than 0.05) than in cows given saline solution or a 25-mug dose of GnRH. Mean progesterone response to the 4 large doses of GnRH was similar in magnitude and duration to serum progesterone changes during the leutal phase of the bovine estrous cycle. After cows were treated with HCG, serum progesterone values were similar to those in cows given GnRH (50 to 250 mug).
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Multiple pigmented follicular cysts: a subtype of multiple pilosebaceous cysts.
Pigmented follicular cyst is a rare disorder which typically presents as a pigmented papule on the head or neck and which, histologically, exhibits terminally differentiated, pigmented hair shafts in an epidermoid cyst. We report a 22-year-old man with the multiple variant of this disorder. Clinically he had numerous brown-blue to flesh-coloured, domed-shaped papules, on the anterior chest and abdomen, of 10 years duration. Histologically, hybrid cysts exhibiting trichilemmal and epidermoid keratinization were seen. The cysts contained numerous pigmented, terminally differentiated hair shafts and, embedded in the wall of one cyst, was a sebaceous gland. The condition of multiple pigmented follicular cysts, is thought to represent a distinct subtype within the spectrum of multiple pilosebaceous cystic disorders.
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[Precocious puberty and ovarian follicular cysts].
Ovarian follicular cysts have been detected by ultrasound in 2 to 8 years old girls with precocious puberty, central puberty (2 cases), transient precocity (1 case) or premature menarche (1 case). Complete regression of the cysts was either spontaneous (1 case) or due to suppressive therapy. The mechanisms of precocious puberty with follicular cysts, dependent or independent of gonadotropins, and their spontaneous evolution guide both the management and the therapy with LH-RH analogues and/or aromatase inhibitors.
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Pigmented follicular cysts.
Pigmented follicular cysts are newly described cutaneous cysts with characteristic histology. They are usually single pigmented lesions occurring in men between 20 and 63 years of age that often are mistaken for nevi. The eighth case of this newly described cyst is presented; a brief review of epithelial cysts and how they differ from pigmented follicular cysts also is reported.
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Follicular cyst in a patient with myotonic dystrophy: a case of cyst with differentiation toward follicular infundibulum, isthmus, inner root sheath, and hair.
We report a case of follicular cyst, which developed in a patient with myotonic dystrophy (MyD). Histopathologically, the cyst showed infundibular and trichilemmal keratinization, inner root sheath differentiation, aggregation of basaloid cells, and pilomatricoma-like changes in the pericystic connective tissue. These findings have been reported in follicular cysts with Gardner's syndrome (GS). Interestingly, pilomatricoma is known as one of the skin diseases associated with MyD, though there have been no reported cases of cyst formation with differentiation toward portions of hair follicle in a MyD patient. In our case, we hypothesized that the cyst might be derived from embryonic follicular germinative cells or follicular stem cells under the genetic influence of the MyD gene, as observed in follicular cysts in patients with GS.
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Pigmented follicular cyst.
A pigmented follicular cyst is an infrequent variant of an epithelial cyst which has rarely been reported since it was first described about 10 years ago. The condition consists of a single pigmented lesion which occurs predominantly in adult men, and is usually located on the head and neck region. We report an example of a pigmented follicular cyst, which was located in the axilla.
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A GnRH/LH surge without subsequent progesterone exposure can induce development of follicular cysts.
Our hypothesis was that follicular cysts would develop if cows experienced an estradiol-induced GnRH LH surge in the absence of an ovulatory follicle. Further, we hypothesized that estradiol would fail to induce a subsequent GnRH/LH surge in these cows until they were treated with progesterone. In experiment 1, seven cows were synchronized with a controlled internal drug releasing device (CIDR) for 9 d and each received 500 microg of cloprostenol on d 7. All follicles (> or = 5 mm in diameter) were aspirated at the time of CIDR removal using transvaginal follicular aspiration. Two days after aspiration, cows were treated with 5 mg of estradiol benzoate (EB) to induce a GnRH/LH surge in the absence of an ovulatory-sized follicle. All cows had an LH surge following the estradiol treatment and three of seven developed an anovulatory condition that resembled follicular cysts. The four cows that did not develop follicular cysts luteinized remaining cells from one aspirated follicle each. Thus, all cows with a progesterone elevation after the estradiol/GnRH/LH surge had subsequent ovulatory cycles, whereas the absence of progesterone was followed by follicular cysts. After 49 d, the anovulatory cows were induced back to normal cyclicity by insertion of a CIDR for 7 d. In two subsequent experiments, nine of 26 cows were induced to have follicular cysts by follicular aspiration followed by 5 mg of EB. After 26 d of observation, all cystic cows received a second treatment with 5 mg of EB and none of the cows showed an LH surge or ovulation. Cystic cows were untreated (n = 4 controls) or treated for 7 d with a CIDR (n = 5). All cystic cows were subsequently treated for a third time with 5 mg of EB. All CIDR-treated cows had an LH surge and ovulated, whereas none of the control cows had an LH surge or ovulation after the estradiol treatment. Thus, a large follicle anovulatory condition, similar to follicular cysts, can be induced by estradiol induction of a GnRH/LH surge in the absence of subsequent luteinization, and this condition prevents a GnRH/LH surge in response to high doses of estradiol. Progesterone eliminates this condition by reinitiation of GnRH/LH surges in response to estradiol.
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Plasma concentrations of inhibin A in cattle with follicular cysts: relationships with turnover of follicular waves and plasma levels of gonadotropins and steroid hormones.
We investigated the profiles of circulating levels of inhibin A and total inhibin in beef cows with follicular cysts in relation to the patterns of follicular development and circulating gonadotropins and steroid hormones. Turnover of follicular waves was monitored in five cows every 2 days for 70 days from 10 days after detection of estrus without ovulation. The mean interwave intervals were 19.6 +/- 1.0 days (n = 18 waves with cysts from the five cows). Circulating levels of inhibin A were approximately 170 pg/ml before emergence of follicular waves with cysts and increased (P < 0.05) concomitantly with follicle emergence. High concentrations of inhibin A (greater than 300 pg/ml) were noted for 7 days during the growth phase of cystic follicles, but inhibin A levels decreased gradually when development of the cysts reached a plateau. This profile of inhibin A was similar to those of total inhibin and estradiol, but was inversely related to the changes in plasma FSH concentrations. LH pulse frequency and mean concentrations of LH in cows with cysts were higher than those observed in the luteal phase of normal cyclic cows. These results indicate that the capacity to secrete inhibin, as well as estradiol, is maintained in cystic follicles, the growth of which is extended by LH secretion at levels greater than those seen in the normal luteal phase. Inhibin A plays an important role in the extension of interwave intervals by suppressing recruitment of a new cohort of follicles.
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A lateral periodontal cyst in association with a follicular cyst.
A case is described in which two separate developmental odontogenic cysts were associated with an unerupted lower third molar tooth. Radiological and histological examination showed that these were a lateral periodontal cyst and a follicular (dentigerous) cyst. This unusual occurrence provides substantial evidence that the periodontal cyst may have an origin from the cell rests of Malassez.
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Comparisons of several dosages of a GnRH analog with the standard dose of hCG in the treatment of follicular cysts in dairy cows.
Two experiments were carried out to examine therapeutic effect of a gonadotropin-releasing hormone analog, buserelin, on ovarian follicular cysts in dairy cows. Follicular cysts were diagnosed by palpation per rectum as well as by milk progesterone assay. Luteinization of the follicular cysts following treatment was judged by an increase in milk progesterone. In Experiment 1, 35 cows were diagnosed to have follicular cysts on the basis of palpations and low milk progesterone concentrations 1 week before treatment. Another 19 cows which were clinically diagnosed with follicular cysts but showed high milk progesterone levels before treatment were excluded. Sixty-two percent (11/18) of cows with follicular cysts treated with 20 microg of buserelin and 82% (14/17) of cows treated with 10,000 IU of human chorionic gonadotropin (hCG) showed luteinization of follicular cysts within 4 to 5 days after the treatments. The percentage of cows conceiving within 100 days after treatment and the average interval in days between treatment and conception were 44% and 42+/-18 (SD) days for the buserelin-treated cows and 47% and 42+/-18 days for the hCG-treated cows. In Experiment 2, the effects of treatment doses (6, 10, 20 and 30 microg of buserelin and 10,000 IU of hCG) on follicular cysts were compared using 103 cows. An additional 23 cows which were clinically diagnosed as having follicular cysts and which were given treatment showed a high milk progesterone concentration on the day of treatment and were therefore excluded. Fifty to 64% of the cows responded with luteinization of follicular cysts after treatment. There was no significant difference in response among cows given either the different dosages of buserelin or the hCG. However, the percentage of the total number of cows that conceived after a single or a repeated treatment with 6 microg buserelin was lower than that of cows after a single or a repeated treatment with 10 microg buserelin (P<0.05). An increase in the dose of buserelin from 10 to 30 microg did not improve the therapeutic effect of the drug. Thus, it is concluded that a single intramuscular injection of buserelin at a dose of 10 microg or higher is as effective as 10,000 IU hCG, and is, therefore, recommended for the treatment of ovarian follicular cysts in cows.
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HPV-related follicular cysts.
Five examples of follicular cysts with papillary projections protruding into the lumen are given. In all cases, the lining was epidermoid. The cystic cavity contained compact, eosinophilic keratinous material. Groups of vacuolated keratinocytes with overlying tiers of parakeratotic cells were seen on the top of the crests. In the intervening valleys, there were irregular clumps of keratohyaline granules. These changes are diagnostic cytopathogenic effects of viral papillomas. However, papillomavirus common antigens were not identified by immunohistochemistry.
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Massive luteinized follicular cyst of pregnancy.
BACKGROUND: A large luteinized follicular cyst can rupture or twist during pregnancy. However, in the absence of those complications a simple ovarian cyst can often be managed conservatively, provided that sonographic evaluation of the cyst is benign. Rapid growth of a simple follicular cyst is rare but may occasionally complicate pregnancy. CASE: A 25-year-old primigravida had a simple-appearing adnexal mass detected by sonogram early in pregnancy. She was followed with serial sonograms. Because of the clear sonolucent appearance of the mass and the patient's preference, a conservative management was elected. The cyst grew in size as her pregnancy progressed, became symptomatic, and necessitated surgical intervention. Cystectomy and cesarean delivery at 36+ weeks relieved the symptoms and achieved delivery of a healthy infant. CONCLUSION: Solitary luteinized follicular cysts of pregnancy have the potential to grow to a very large size and create complications related to their size alone. Conservative management of simple adnexal cysts in pregnancy, based on their sonographic appearance, can avoid risks of abdominal surgery in the second trimester of pregnancy, but in the third trimester, a large cyst can create significant complications requiring surgical intervention.
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Ovarian follicular cysts in dairy cows.
Ovarian follicular cysts are anovulatory follicular structures that occur in 10 to 13% of dairy cows. This review focuses upon the dynamics of cyst growth, development, and persistence as well as on associated endocrine and cellular mechanisms. During the estrous cycle of cows, two to four waves of follicular growth occur. From a cohort of recruited follicles, one is selected for continued growth and dominance while the other undergo atresia and regress. In contrast, cysts have long been thought to be static structures that persist for extended periods. Although cysts can persist for extended periods, most regress over time and are replaced during subsequent follicular waves. The next dominant follicle either ovulates or develops into a new cyst. The recruitment of a cohort of follicles from which a cyst develops and the growth rate of cysts to ovulatory size are similar to ovulatory follicular waves, but the cyst continues to grow for a longer period. The interval between waves of follicular growth is longer for cows with cysts than for cows with normal estrous cycles. Each wave is preceded by a transient increase in circulating FSH. Near the time of cyst development and persistence, the concentration of FSH is not different from that during normal estrous cycles. Serum concentrations of LH and estradiol-17 beta are higher in cows that develop cysts than in cows that do not. Conversely, hypothalamic content of GnRH is lower in cows with cysts. Thus, cysts are dynamic structures, and their development and lifespan are likely associated with altered hypothalamic-hypophysial-ovarian function.
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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).
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Ovarian follicular cysts in dairy cows: an abnormality in folliculogenesis.
Ovarian follicular cysts are a major reproductive problem in lactating dairy cows. The primary physiological defect leading to the formation of ovarian follicular cysts is a failure of the hypothalamus to trigger the preovulatory surge of luteinizing hormone (LH) in response to estradiol. The factor responsible for this hypothalamic defect may be progesterone. Intermediate levels of progesterone have been shown to prevent ovulation and promote persistence of dominant follicles in normal cycling cows. Recently, we found that 66% of cows with ovarian follicular cysts had progesterone concentrations in an unusual, intermediate range (0.1-1.0 ng/mL) at the time of their detection. A majority of new follicles (76%) that develop in the presence of these intermediate progesterone concentrations became cysts. Only 10% ovulated. Based on these observations, a novel model for the formation and turnover of ovarian follicular cysts is proposed.
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