This site is targeted at medical and radiology professionals, contains user contributed content, and material that may be confusing to a lay audience. Use of this site implies acceptance of our Terms of Use.

Nabothian cyst

Nabothian cysts (also knwon as a retention cysts of the cervix 11) are non-neoplastic cystic lesion that occurs in relation to the uterine cervix.

Epidemiology

They are common and some reports suggest that they may seen in up to 12% of routine pelvic MRI scans 2.

Clinical presenation

Majority are asymptomatic, although in rare cases they can enlarge and become symptomatic 12.

Pathology

They are thought to form as a result of the healing process of chronic cervicitis and represent mucinous cysts due to obstruction from overgrowth of squamous epithelium. 

Symptomatic nabothian cysts can also occur as a late complication of subtotal hysterectomy, in which internalisation of the transformation zone and partial obliteration of the canal are postulated as predisposing factors.

Size

Nabothian cysts are usually small spanning a few millimeters in diameter but on occasion, have been reported reach extreme sizes of up to 4 cm.

Variants

Tunnel cluster - a special type of Nabothian cyst, is characterized by complex multicystic dilatation of the endocervical glands 

Radiographic features

Pelvic ultrasound

Typically seen an anechoic well defined cystic lesions near the endocervical canal. If the cysts are large, the cervical region can appear enlarged 11. Colour Doppler interrogation show no associated colour flow.

Pelvic MRI

They may be seen as well circumscribed single or multiple cystic lesions within the cervical stroma.

Signal characteristics typically follow that of fluid 2.

  • T1
    • iso to hypo intense relative to muscle in typical cases
    • very rare cases with mucin may show some high signal
  • T2 - cysts are hyper intense relative to muscle
  • T1 C+ (Gd) - there is no associated enhancement
CT

If small may not be detectable on CT. May occassionally be seen a focal low attenuation regions within the cervical region.

Significance

Most Nabothian cysts are clinically insigificant. Majority of  cases are not treated because the cysts are entirely benign; however, an excision biopsy is sometimes indicated in large, complex, cystic lesions to rule out rare forms of mucus-producing neoplasia, including adenoma malignum 12

Differential diagnosis

General imaging differential considerations include

Updating… Please wait.
Loadinganimation

Alert_accept

Error Unable to process the form. Check for errors and try again.

Alert_accept Thank you for updating your details.