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Bartholin gland cyst

Bartholin gland cysts are located in the postero-lateral inferior third of the vagina and are associated with the labia majora.

Clinical presentation

Most patients are asymptomatic 4

Pathology

Chronic inflammation can lead to ductal obstruction from pus or thick mucus which in turn can result in retained secretions within the Bartholin glands. 

Radiographic features

General

They are typically seen as rounded unilocular cysts lying at the posterior aspect of the vagina. Their location is at or below the level of the pubic symphysis (best appreciated on coronal imaging).

Ultrasound

May only be demonstrated on trans-perineal ultrasound as the cyst is close to the labia.

MRI

Signal characteristics include:

  • T1 - can be of variable signal
  • T2 - often of uniform hyper-intensity on T2-weighted imaging although can occasionally vary dependent on protein content, may also be heterogeneous when infected

Complications

  • infection: may turn into Bartholin gland abscesses 
  • rare instances of development of adenocarcinoma or squamous cell carcinoma within cyst 5

Treatment and prognosis

Infected or symptomatic cysts may require marsupialization.

Differential diagnosis

General imaging differential considerations include:

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