Endometriosis: Clinical Manifestation and Differential Diagnosis
Nazar N. Amso, Saikat Banerjee in Endometriosis, 2022
The finding of a pelvic mass will raise alarm bells for the clinician and the patient. Ovarian endometriomas occur in 17–44% of patients with endometriosis and account for 35% of all benign ovarian cysts (72). One should notice the persistent nature of the cyst and the evolution of further symptoms. Endometriomas tend to be fixed and tender, and bimanual examination often reveals nodularity and fixation of pelvic structures. Pelvic ultrasound assessment is the mainstay for characterizing a pelvic mass. Pattern recognition and diagnostic models together with the Ca125 may help the differential diagnosis. In postmenopausal women, the priority is to exclude malignancy. Complex adnexal masses may require further imaging modalities and a multidisciplinary approach. The Royal College of Obstetricians and Gynecologists (RCOG) guidelines do not recommend doing Ca125 in endometriosis diagnosis or follow-up.
Observing and Describing Disease
Jeremy R. Jass in 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.
Pathogenesis of Odontogenic Cysts
Roger M. Browne in Investigative Pathology of the Odontogenic Cysts, 2019
If the initiation of cyst formation is genetically determined, it is not known whether the abnormality is acquired or hereditarily transmitted and whether it affects the epithelium or the cells of the cyst capsule. A heredity transmission is suggested by the evidence previously quoted of a peak incidence in the second and third decades and an association with the basal cell nevus syndrome. However, odontogenic keratocysts are diagnosed in patients up to the ninth decade of life and several studies have demonstrated a second peak of incidence in the fifth or sixth decade,13,17,23,65–67 which suggests an acquired abnormality may also play a role. This bimodal age distribution may indeed indicate two distinct groups of patients who suffer from this condition. The views have been expressed that odontogenic keratocysts are either hamartomas1 or benign cystic neoplasms,14,68 although the evidence for both points of view is equivocal. The possible neoplastic nature of these cysts is discussed further in Chapter 11.
Ocular Toxoplasmosis
Published in Ocular Immunology and Inflammation, 2022
Eunice Jin Hui Goh, Ikhwanuliman Putera, Rina La Distia Nora, Padmamalini Mahendradas, Jyotirmay Biswas, Soon-Phaik Chee, Ilaria Testi, Carlos E Pavesio, Andre Luiz Land Curi, Daniel Vitor Vasconcelos-Santos, Atul Arora, Vishali Gupta, Alejandra de-la-Torre, Rupesh Agrawal
T. gondii has a unique biphasic life cycle, a sexual cycle that occurs only in felines (definite hosts) and an asexual cycle in other animals, including humans (intermediate hosts). Cats acquire the infection by ingesting oocysts which replicate in its intestines and these oocysts are then formed and excreted. They are infectious after 24–48 hours, depending on temperature and humidity.8 Humans in contact with cat faeces, water, fruits or vegetables contaminated with T. gondii oocysts could inadvertently ingest them.1 The asexual phase begins after ingestion of the oocysts, where they rupture, releasing sporozoites that divide to become tachyzoites, which spread throughout the body. Tachyzoites are the fastest replicating form, responsible for systemic dissemination and active tissue infection in intermediate hosts. With sufficient immune response, tissue cysts will eventually develop, containing bradyzoites, which are the low-replicating forms of the parasite that cause latent infection. However, bradyzoites can transform into tachyzoites when released from tissue cysts.9 Tissue cysts indicate the chronic stage of infection and persist for long periods in the host, inducing a continuous stimulation of the immune system, which leads to a protective, although not sterilizing, immune response.10–12
Evaluation of the effectiveness of the tuba uterina tubular flap in the peripheral nervous system regeneration in rats
Published in Journal of Plastic Surgery and Hand Surgery, 2022
Mehmet Emin Cem Yildirim, Mehmet Dadaci, Bilsev Ince, İlker Uyar, Serhat Yarar, Pembe Oltulu, Recep Aygul
Bioengineering and nanotechnological advances will allow biodegradable nanomaterials to be used as new nerve conduits. However, thanks to tissue, cell and genetic engineering, it will be possible to add supporting cells containing stem cells to the conduit, or to produce various lumen structures that can increase nerve regeneration. Our study investigated whether the motile cilia structures, their directions and secreted molecules for the survival of spermium and ovarium secreted from the lumen epithelium in the rat tuba uterina will contribute to the nerve regeneration. However, during a three-month of follow-up, it was observed upon macroscopic assessment that eight of the 20 rats in the flap groups (Flap-Forward and Flap-Reverse groups) had serious cystic formations. The reason for these cysts was thought to be the inability of the epithelium secretions to drain to the outside properly. While planning the study we had hoped that using as few stitches as possible would prevent the formation of these cysts.
Ophthalmic Manifestations of Rathke’s Cleft Cyst and Its Association to Radiological Characteristics
Published in Current Eye Research, 2021
Hyeshin Jeon, Hie Bum Suh, Woohyun Chung, Hee-young Choi
Rathke’s cleft cyst (RCC) is a benign epithelial-lined cyst formed by the failure in the obliteration of the embryonic cleft of the Rathke’s pouch located in the sellar and suprasellar region1; however, its pathogenesis remains controversial.2 Most RCCs are usually small, asymptomatic, and remain stable during life, and therefore, are usually incidental findings.1,3 Though symptoms with RCC are rare, where they do occur then headache, endocrine dysfunction, and visual disturbance are the commonest presenting symptoms. Symptoms occur if the cyst enlarges and compresses the surrounding structures.4–6 Ophthalmic manifestations include decreased visual acuity, visual field defect, and diplopia, and the incidence varies between 14% and 90%, possibly due to differences in the inclusion criteria among the reported studies and inconsistencies in objective ophthalmic evaluations.6–8