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Benign Neoplasms
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Abdullah Demirbaş, Ömer Faruk Elmas, Necmettin Akdeniz
Definition: Cutaneous cysts are sac-like lesions containing liquid or semisolid material. Although genetic and environmental factors can impact the occurrence of cysts, the etiologic reasons are unclear. There are many types of cysts that differ in their histologic features.
Common Tips on Communication
Published in Justin C Konje, Complete Revision Guide for MRCOG Part 3, 2020
How are borderline tumours treated? Most of the time, the diagnosis is made from an examination of a cyst that has been removed during surgery. If the whole ovary has been removed, then all that would be needed is a follow-up.
Observing and Describing Disease
Published in Jeremy R. Jass, Understanding Pathology, 2020
A cyst is a collection of fluid or semi-solid material that is enclosed within a sac with an epithelial lining. Cysts are formed on the basis of simple obstruction of an otherwise normal gland or tubule, as a complication of tissue maldevelopment, in the course of neoplastic change or in the context of parasitic invasion (e.g. hydatid disease). The contents of cysts will vary according to the type of underlying epithelium: keratin in the case of epidermal or pilar (sebaceous) cysts, protein-rich fluid in the case of either simple or neoplastic cysts lined by a serous epithelium, mucin in the case of neoplastic cysts lined by mucinous epithelium, and sebaceous material in benign ovarian teratomas (dermoid cysts). The more fluid contents will be lost within museum preparations but mucin may persist as transparent, semi-opaque or opaque glairy material.
Spinal cord atrophy following the resection of multiple intraspinal arachnoid cysts: case report and literature review
Published in British Journal of Neurosurgery, 2023
Wenyan Li, Chenghai Zuo, Hua Feng, Hui Meng
To the best of our knowledge, post-surgery atrophy of spinal cord is for the first time associated with multiple spinal arachnoid cysts. On imaging, our case appeared like a relentlessly progressive arachnoiditis, except that there was no known provoking factor. The surgical findings were of bland arachnoid cysts, and these were confirmed on histology, and these alarmingly progressive imaging findings were not associated with progressive neurology. There are only a couple of reports similar to this case.4,5 In a case report, Zekaj et al.5 found intramedullary cyst formed following the resection of spinal arachnoid cysts. The patient complained of radicular dorsal pain a few months after the total removal of the cysts. Follow-up MRI demonstrated an expansion of central canal and an intramedullary arachnoid cyst. Their explanation was that the scar adhesion from the surgical procedure led to the cyst development.
Mid thoracic intra-spinal facet cyst with lumbar canal stenosis: a rare ‘double crush’
Published in International Journal of Neuroscience, 2023
Abhinandan Reddy Mallepally, Nandan Marathe, Jeevan Kumar Sharma, Bibhudendu Mohaptra, Kalidutta Das
FC of dorsal spine is an uncommon cause of spinal stenosis causing symptomatic radiculopathy or myelopathy requiring surgical decompression. Dorsal spine has relatively lowest range of motion and it has the least common site of occurrence of FC (about 1.5%) [10]. One of the hypothesis for a thoracic FC suggests decreased disc height causing increased facet-joint motion resulting in segmental instability. This increases capsule pressures in lateral bending and axial rotation finally resulting into a FC [11]. Increased production of hyaluronic acid and proliferation of mesenchymal cells in degenerative process also contributes to the formation of FC. Mechanical load causes flare of inflammatory process and sets off a cascade of reactions. Chemokines including IL-1, 6, PDGF, FGF, VEGF and substance P are released. They cause neovascularization, form fluid exudate and cause synovial membrane hyperplasia. This membrane is protruded through the anatomical defect forming a FC [5,12]. In few cases, after reducing the mechanical load and resolution of the inflammatory process, spontaneous decrease in size of the FC has been observed [13]. The content of cyst is usually mutinous in consistency, with proteinaceous material and sometimes gaseous.
Pneumocystis jirovecii: a review with a focus on prevention and treatment
Published in Expert Opinion on Pharmacotherapy, 2021
R. Benson Weyant, Dima Kabbani, Karen Doucette, Cecilia Lau, Carlos Cervera
Unlike many other fungi, PJ does not have ergosterol in its cell wall. This makes it immune to both the azoles and polyenes, two of the most frequently used antifungal classes. Echinocandins competitively inhibit β-1,3-D-glucan synthase and prevent the synthesis of β-1,3-D-glucan (BDG), a different component of fungal cell walls. Currently they are only available in parenteral form, owing to poor oral absorption. Most of what we know about their anti-pneumocystis properties is from animal models. Murine models have found echinocandins to be effective for prophylaxis and treatment of pneumocystis, with caspofungin and anidulafungin more effective that micafungin [105,106]. As discussed before, only the cyst form of pneumocystis species has BDG, and therefore echinocandins are not effective against the trophic form, the predominate form in the alveoli. By specifically targeting PJ cysts with anidulafungin, infected mice were unable to transmit PJ to other mice [106]. This suggests that the cyst form is essential for transmission of infection. However, in these same murine models the trophic form remains in the lungs after echinocandin treatment, allowing for the repopulation of cyst forms. This suggests that monotherapy may not be adequate, and echinocandins may be best suited as part of combination therapy. A theoretical drawback to echinocandin therapy, is that if started before the diagnosis of PJP is confirmed, it may decrease the sensitivity of stains that detect the cyst form such as Grocott’s methenamine silver stain [106].