Letteratura scientifica selezionata sul tema "Non-epithelial cyst"

Abnormalities of the cilium, termed ‘ciliopathies’, are the prime suspect in the pathogenesis of renal cyst formation because the gene products of cystic disease-causing genes localize to them, or near them. However, we only partially understand how cilia maintain the geometry of kidney tubules, and how abnormal cilia lead to renal cysts, and the diverse range of diseases attributed to them. Some non-cystic diseases share pathology of the same structures. Although still incompletely understood, cilia appear to orient cells in response to extracellular cues to maintain the overall geometry of a

This chapter covers gynaecological pathology and includes vulval skin diseases, benign vulval tumours, vulval carcinoma, vaginal infections, vaginal tumours, cervical carcinoma, cervical screening, endometriosis, endometrial carcinoma, uterine leiomyomas (fibroids), uterine leiomyosarcoma, functional ovarian cysts, benign non-epithelial ovarian tumours, benign epithelial ovarian tumours, borderline epithelial ovarian tumours, ovarian carcinomas, pelvic inflammatory disease, ectopic pregnancy, polycystic ovarian syndrome, hydatidiform mole, and pre-eclampsia.

Odontogenic cysts and tumours arise from inclusion of tooth-forming epithelium and mesenchyme in the jaw bones during development. Cysts also arise from non-odontogenic epithelium trapped during fusions or from vestigial structures. In addition, bone cysts that can arise at other skeletal sites may also occur in the jaws. Odontogenic cysts and tumours may be classified according to their putative developmental origins and biology. The classification of jaw cysts is shown in Fig. 6.1. Odontomes are hamartomatous develop­mental lesions of the tooth-forming tissues. Odontogenic tumours are uncommon and are usually benign. Ameloblastoma is the most com­mon odontogenic tumour and is described in detail. The other odon­togenic tumours are rare and only the principal features are presented. Very rare congenital lesions of possible odontogenic origin are men­tioned in the final section. A cyst may be defined as pathological cavity lined by epithelium with fluid or semi-fluid contents. However, clinically, the term encompasses a broader range of benign fluid-filled lesions, some of which do not possess an epithelial lining. The preferred definition is, therefore, ‘a pathological cavity having fluid or semi-fluid contents that has not been created by the accumulation of pus’. Cysts are commonly encountered in clinical dentistry and are generally detected on radiographs or as expansions of the jaws. Most cysts have a radiolucent appearance and are well circumscribed, often with a corticated outline. At least 90% of jaw cysts are of odontogenic origin. The clinico-pathological features of jaw cysts are summarized in Table 6.1. The incidence of the four most common jaw cysts are provided in Table 6.2. The epithelial lining of odontogenic cysts originates from residues of the tooth-forming organ. • Epithelial rests of Serres are remnants of the dental lamina and are thought to give rise to the odontogenic keratocyst, lateral periodon­tal, and gingival cysts. • Reduced enamel epithelium is derived from the enamel organ and covers the fully formed crown of the unerupted tooth. The dentiger­ous (follicular) and eruption cysts originate from this tissue, as do the mandibular buccal and paradental cysts. • Epithelial rests of Malassez form by fragmentation of Hertwig’s epi­thelial root sheath that maps out the developing tooth root. Radicular cysts originate from these residues.

The four most common diagnoses for a breast lump are: • Benign cystic change (also known as fibrocystic change, fibroadenosis, or benign breast change) • Fibroadenoma • Cyst • Carcinoma If we consider women of all ages, there are a number of other potential diagnoses: • Fat necrosis • Periductal mastitis • Abscess • Galactocele • Phyllodes tumour • Sarcoma • Duct papilloma • ‘Non-breast’ lumps, e.g. lipoma, sebaceous cyst, prominent costal cartilage/rib. The age of the patient is one of the most useful pieces of information for narrowing the differential. As an approximate guide, the most common diagnoses in the following age groups are: • <30 years: physiologically normal lumpy breast; benign cystic change; fibroadenoma; abscess (if breast-feeding); galactocele (if breast-feeding) • 30–45 years: benign cystic change; cyst; abscess (especially smokers); carcinoma • 45–60 years: cyst; abscess (smokers); carcinoma • >60 years: carcinoma ▲ Note: It is worth emphasizing that breast cancer is possible in all ages, is common, and is potentially very serious. Therefore you must exclude it in any presentation of breast lump, regardless of how benign it seems. Failure to diagnose breast cancer is one of the most common malpractice claims in the USA. Galactoceles may occur during or shortly after the cessation of lactation. They may present as a firm mass (often subareolar) and are caused by the obstruction of a lactiferous duct. The duct gradually becomes more distended with milk and epithelial cells, and may rarely be complicated by a secondary infection leading to abscess formation. Clinically, a galactocele is very similar to a cyst on examination. In addition, lactating women are predisposed to mastitis (whether or not they have a galactocele). The causative organisms are usually skin commensals such as Staphylococcus aureus or Staphylococcus epidermidis—this is in contrast to the periductal mastitis and abscess formation seen in older women, in whom anaerobic bacteria may also be implicated. Two of the greatest risk factors for breast cancer are being female and increasing age. Otherwise, the following are recognized as important factors: • Previous breast cancer • Family history of breast cancer. Suspicions should be raised if: ■ Three close blood relatives (on the same side of the family) develop breast cancer at any age

Background: Cancer antigen 19-9 (CA 19-9) is a tumor-associated mucin glycoprotein antigen that may be elevated in healthy individuals as well as in patients with benign and malignant tumors. It is useful in the management of pancreatic and other gastrointestinal tumors. CA 19-9 is also elevated in benign and malignant ovarian tumors. Aim: To study the pattern of serum CA19-9 in complex ovarian tumors. Methods: The study design was descriptive, based on data collected from medical records. Patients with a complex ovarian mass, who were investigated with CA 19-9 and had undergone surgery, werei

Background: Cancer antigen 19-9 (CA 19-9) is a tumor-associated mucin glycoprotein antigen that may be elevated in healthy individuals as well as in patients with benign and malignant tumors. It is useful in the management of pancreatic and other gastrointestinal tumors. CA 19-9 is also elevated in benign and malignant ovarian tumors. Aim: To study the pattern of serum CA 19-9 in complex ovarian tumors. Methods: The study design was descriptive, based on data collected from medical records. Patients with a complex ovarian mass, who were investigated with CA 19-9 and had undergone surgery, were