Choroid plexus cyst

The choroid plexus is a part of the brain that is responsible for the development of cerebrospinal fluid. It is like pockets that are called ventricles, which contains spongy layer of cells with blood vessels. It is present in the centre of the fetal brain. The cyst that occur within choroid plexus is called choroid plexus cyst. The fluid which is produced by the choroid plexus cells fills the ventricles and flows around the brain plus spinal cord to provide a cushion around these structures. The cysts form within these structures and the fluid trapped within this spongy layer of cells is much like a blister or a soap bubble. The choroid plexus cysts are often called as fetal ultrasound “markers” and “soft signs” , because it is found that there is a weak connection between fetal chromosomal abnormalities and choroid plexus cysts. The fetal chromosomal abnormalities are diagnosed by a procedure known as aminocentesis. The tiny choroid plexus cysts usually form in the brain as a normal part of the development in many fetuses, but disappears by the 32nd week of pregnancy.

The choroid plexus cysts are not true cysts as these have no epithelial lining, but are spaces filled with clear fluid within the choroid plexus. The size of these cysts range from a one to few mm to 1-2cm in diameter. Sometimes these cysts are responsible for obstructive hydrocephalus. This is caused by foramina blockage in the ventricular drainage system of central nervous system, which results in expansion of the ventricles and compressing the brain that cause severe damage.

Chocolate Cyst

Chocolate cyst is one of the many types of cysts of ovaries. It is also called an endometrioma, chocolate ovarian cyst and endometrial cyst. It is a pouch or sac growing on the ovary which contains fluids and semi-solid materials which results in complex ovarian cyst. The endometrial tissue present inside the cyst responds to the monthly hormones, so it bleeds and fills the cysts with unclotted blood. As this blood gets old with time and changes into the dark color that resembles the chocolate, so it is called as a chocolate cyst.

In this disease, the tissue of the internal surface of uterus (i.e. endometrium) attach to the ovary in the form of patches, which may form small cysts. These small cysts are multiplied when the hormones responsible for menstruation stimulate them. After increasing in number, these cysts become the part of the ovary by replacing the normal tissues which are involved in ovulation. These cysts also spread around the pelvic cavity which causes inflammation and irritation of the nearby organs.

This disease affects millions of women each year especially during their childbearing years. This cyst affects the left ovary in most cases. The major bugbear with the chocolate cyst is that once they get finish, can recur at any stage of life. The endometrioma size ranges from about half an inch to four inches or more in diameter. If the cysts are small and only one then it will not interfere with pregnancy, but if multiple cysts are present and large in size then it can be dangerous for the fertility of women.

Chocolate cysts show no symptoms in some cases, but in some cases the symptoms are severe. The severity of symptoms are not dependent on the progression of the disease. However, some important symptoms are given below.

.Swelling or abdominal cramping during menstrual cycle.

.Painful periods.
.Uncomfortable sexual intercourse.
.Pain during exercising, bending or stretching.
.Bleeding other then the menstrual cycle at odd times.
.Dark colored discharge from the vagina.
.Pressure and pain during bowel movement or emptying the bladder.
.Weight gain.

The chocolate cysts can cause serious problem, if it get rupture. Because the contents may spill out on the ovaries and other organs in the pelvis which can lead to severe complications such as infections, scarring or adhesion and intense pelvic pain. This can also cause excessive bleeding, vomiting, fever and severe pain.

The treatment for the chocolate cysts include medication with drugs, such as Danzol and GnRH. But these drugs will only relieve the symptoms and not be helpful in removing the cysts. Other treatment is surgery, but it has some other problems as well. As during the removal of cyst sometimes some part of the ovary or in some cases the complete ovary has to be removed which results in lowering the fertility in women. Moreover, unnecessary surgical treatment can cause damage to other organs too, such as rectum or bladder.

Chalazion cyst

A chalazion is a fluid filled swelling or a small cyst that measures about 2-8mm in size. It may be firm or soft. It can occur on one or both eyelids together on either upper or lower side. It is not a tumor and does not cause any permanent changes in the eye sight. It is usually common and goes away without any operation or surgery. A chalazion is also called as tarsal cyst, meibomian cyst or conjunctival granuloma.

The eyelid glands are known as meibomian glands, tarsal or palpebral glands, or tarsoconjunctival glands. These are about 30 to 40 glands on each side of the eye lid. These glands lubricate the surface of the eye by producing a thick liquid secretion which is a mixture of oil and mucus. This secretion is called as sebum. These glands or tiny sebaceous openings are present just behind the eye lashes at the lid margins, on both upper and lower eyelids. Sometimes these narrow openings of meibomian glands can get blocked due to hardening of the sebaceous liquid near the openings and stop the fluid to escape which swells into a cyst.

Chalazion is different from styes or hordeola as these are subacute and nodules are usually painless. Moreover, it affects the inner side of the lid mostly rather than the lid margin.  In normal cases, a chalazion does not get infected, but over time, inflammation causes a granuloma or a nodule to form that is a lump in a firm condition that takes a long time to get finish. This lump is actually a chalazion. It mostly affects those people who have skin diseases like eczema or blepharitis.

Some signs and symptoms are as follows :
.Swelling and irritation on the eyelid
.Tenderness of eyelid
.Increased tearing
.Sensitivity to the light
.Heaviness of the eyelid
.Distorted vision

As the chalazion is not malignant and contagious, so the treatment of this cyst is quite simple in some cases i.e., when chalazion doesn’t cause problem, it can be cured with time (between 2-6 months), as about 25 – 50% of people get cured without any treatment. If the chalazion is causing problem, then a method known as hot compress can be applied for the treatment. In this method, just hold a clean flannel dipped in hot water and put it on the affected eye gently, but firmly. Do this for 5-10 minutes and repeat it for about 3-4 times in a day. The warmth and the pressure softens the cyst which helps it to drain easily. After this hot compress a gentle massage with clean finger can help the cyst to drain and finish. Other than this, daily cleaning the eyes with water or with a mild baby shampoo can help to remove the grease and grime which allows the cyst to form. After all these treatments, if the cyst is still persists, then surgery is the only treatment to get rid of it. An operation under local anaesthetic can be done. A small cut is made inside the eyelid after making it numbed, and then the cyst contents are released. Moreover, the antibiotic drops and ointments are used to finish the cyst.

Usually the cyst does not cause a major problem, but if it gets infected then it can spread on the whole eyelid and the surrounding tissues of the eye. This can result in difficulty in opening the eyes as the eyelid becomes red and swollen.

Moreover, it can cause severe pain along the fever. In this condition, it is important to see the doctor. However, it may cause blur vision which becomes normal once the cyst is removed.

The recurrence of a chalazion is very rare, but in some people it may develop again. This recurrence can be stopped by using method of hot compressing and massaging daily.

Ceruminous cyst

Ceruminous glands are the sweat glands present in outer auditory canal. These glands are simple, tubular, coiled made up of an outer myoepithelial layer of cells and inner secretory layer of cells. These glands drain in to the larger ducts, which again drain in to the guard hairs that are present in the external auditory canal where they produce earwax which is called as cerumen. Cerumen helps in keeping the eardrum lubricated, cleaning the external auditory canal, killing the bacteria, keeping the canal waterproof, and coating the guard hairs making them sticky which serves as a barrier for the foreign particles such as fungal spores, dusts etc.

These glands can develop cysts and tumors. The cysts in ceruminous glands are called as ceruminous cystomatosis. It is an uncommon non-neoplastic skin disorder of cat’s ears. These lesions are benign and affect the concave pinna and external auditory canal’s opening in most cases, but rarely affect the auditory canal. These lesions can be dangerous if left untreated because it may affect the secondary otitis externa. This can be a congenital disease (present from birth), but this condition can affect the cats of all ages, but seen most common in middle aged and older cats. The diagnosis is easy due to the appearance of the dark papules.

Cyrosurgery is a technique that is commonly used for the treatment. In this surgical process the liquid nitrogen or nitrous oxide is used to freeze the unwanted tissue and then destroy it. The frozen tissue take upto 4 weeks to fall off or dissolve. This technique is very little painful for the pets. Ther is one more method used for the treatment that known as carbon dioxide surgical laser. This technique allows for fine tuned ablation that results in minimal deformation of the pinna, because this ablation causes scar formation and tissue damage.

Pineal Love Cyst

A cyst in the pineal gland is called pineal love cyst. What is pineal gland and why the cyst is called as pineal love? The pineal gland is a part of endocrine system in the brain and situated exactly between the eyes which is the centre of the brain. It is pine cone shaped and size is equal to a pea. This gland is also known as the third eye as it allows us to have senses and to feel. It allows the brain to regulate consciousness and to interpret the body’s sensory functions. This gland sometimes effected by a cyst which is usually benign and asymptomatic in small size, but if these are large i.e. more than 5.0 mm,  which are very rare, then these show a variety of symptoms as headache, visual disturbance, unexpected seizures, loss of consciousness, muscle fasciculations, circadian rhythm dysfunction, light sensitivity etc. Sometimes if the cyst effects the superior colliculi ( paired structure of midbrain in mammals) or it causes obstruction of the cerebral aqueduct then it results in hydrocephalus ( a condition in which the cerebrospinal fluid accumulates in the brain abnormally). In these cases the cyst should be removed as soon as possible. The recent advancements in the endoscopic medicine have allowed to remove the cyst by endoscopic brain surgery that takes only one night in the hospital and the patient recovers within a week unlike the patient who undergoes the open skull brain surgery.

The cause of the pineal cyst is not known, but one theory tells that the hormonal imbalances during the menstruation or pregnancy play an important role in the development of these cysts. Another theory tells that if hemorrhaging occurs in the pineal region then the bleeding can cause the cyst to develop and grow in size. These cysts are diagnosed by CT scan and MRI.

Pineal tumors are different from pineal cyst. They can be cystic in appearance, but can be distinguished by microscopic examination of affected tissue in which it is shown clearly that the pineal cysts have three concentric layers:
1. Inner layer: Glial tissue containing hemosiderin.
2. Middle layer: Pineal parenchyma cells layer.
3. Outer layer: Connective tissue layer which is thin and fibrous.
With the help of this examination we can differentiate pineal cyst from pineal tumor.

Buccal Bifurcation Cyst

The buccal bifurcation cyst was first identified and described in 1983 by Worth and Stoneman. This lesion is present on a specific location i.e., buccal surface of the mandibular first and second molar. It mostly occurs in the children of age 5 to 10. This infection is usually associated with pain. It is also called as a mandibular infected buccal cyst and paradental cyst.

There are some important radiographic features of this cyst:

LOCATION : Its region is furcation and mostly occurs in the permanent mandibular first molar.
EDGE : Its edge is well defined and well localized.
SHAPE : Oval or round.
INTERNAL : Unilocular and radiolucent.
NUMBER : Mostly single.

This cyst is associated with the vital tooth and when occurs it is very clear to identify as the lingual cusps appear higher than the buccal cusps due to tilting. When it enlarges, it resorbs or displaces the adjacent teeth. It may cause swelling of buccal cortex , pain and infection.

The former treatments of this cyst was extraction or root canal of the infected tooth. The current treatments are with the preservation of the infected tooth. There are 44 cases of the treatment of this cyst that are done only by enucleation without removal of involved tooth.

Bartholins Cyst

The both sides of vaginal openings consist of some glands known as Bartholin’s glands. These glands are helpful in lubrication of vagina as they secrete fluid. In some cases, the glands openings are obstructed that causes the fluid to remain in the gland and that results in painless swelling which is called Bartholin’s cyst. It usually occurs on only one side of the vaginal opening. Sometimes the fluid in cyst gets infected which causes a pus in the specific area that is surrounded by abscess (inflamed tissue). The treatment of these cysts depends on its size, infection and pain. If it is small and painless it can be treated at home, if it is painful and big in size it needs surgical drainage, and in case of infection cyst then antibiotics are used.

In start the cyst is usually small and painless, it can disappear by itself but if it grows it may feel like a lump near the vaginal opening. It can be infected easily. In this case the patient may feel the following symptoms:

1. A soft, painful lump near the openings of vagina
2. Uncomfortable walk
3. Itching and fever
4. Uncomfortable or painful intercourse

The main cause of Bartholin’s cyst is fluid accumulation in the Bartholin’s glands which may be is a result of any other infection or some injury. The infection in these cyst may occur due to bacterias such as Escherichia coli , chlamydia and Neisseria gonorrhoeae (the bacteria that causes sexually transmitted disease gonorheae). These cysts can be cured by surgical treatment, but the main problem is that it may occur again on the same place.
Some important and useful treatments in curing the Bartholin’s cysts are given below:
1. Sitz baths : Fill a tub with warm water and soak the infected area in it. Repeat it many times for three to four days to rupture the infected cyst.
2. Drainage of cyst by surgery : After applying the local anesthesia, the doctor makes an incision in the infected cyst and drain it, then a catheter (a small rubber tube) is placed in the incision and leave it there for about six weeks to allow the cyst to drain completely. This procedure is called as surgical drainage.
3. Marsupialization : If the cyst occur again after the treatment then marsupialization is done. In this procedure, doctor applies stitches on each side of the incision so that a permanent opening of about 1/4 inch in size forms. A catheter is palced again to allow complete drainage and prevent the infection and cyst to occur again.
4. Antibiotics are also used to treat the infected cysts.

In women who are older than 40 and get these cysts on their vaginal openings then they should be more concerned because it may be some cancerous cells.

Baker’s Cyst

A Baker’s cyst is a pocket like lump filled with fluid that is present behind the knee. This bulge causes a feeling of tightness in the knee. It even get worse if the leg is stretched or during active movements. It is also named as popliteal cyst.

Synovial fluid i.e., a lubricating fluid is naturally present in the knee which helps it to swing, move smoothly and reduce the friction in the joint. In some cases the knee produces so much synovial fluid that results in the formation of popliteal bursa causing a Baker’s cyst. It is formed when excess fluid accumulates behind the knee by the diseases such as osteoarthritis or rheumatoid arthritis. These diseases affect the joints and especially irritate the knee joint. The fluid forms a sac of tissues and bulges out behind the knee, that is called a cyst. This cyst can also form in a result of an injury.

Usually Baker’s cyst never cause any pain but its symptoms include:

  • Stiffness or tightness behind the knee
  • Pain in the upper calf and behind the knee when the leg is bend or straighten up
  • Swelling occurs that gets worse when the body is stretched

Some complications may occur if the cyst bursts out and leaks the synovial fluid in the calf region that results in calf swelling and redness, knee pain and feeling of water flowing down in the calf.

Baker’s cyst diagnosis is usually done by a physical exam, but some of its symptoms resemble the symptoms of other diseases such as Aneurysm or tumor, blood clot etc. So to do the perfect diagnosis following imaging tests are required:

  • MRI
  • X-ray
  • Ultrasound

Usually small Baker’s cysts disappear on there own, but if it is big and causes pain then medications and treatments are important.

  • The medication includes corticosteroids i.e., cortisone that is induced in the knee to reduce inflammation, but it just relieves the pain and doesn’t prevent reformation of the cyst. More medicines include ibuprofen and naproxen.
  • Drainage of the fluid from the knee joint with the help of a needle. This process is called as needle aspiration and is performed under ultrasound.
  • Some healthy and strengthening exercises can also help in preserving the function of knee.
  • A crutch or cane and compression wrap around the knee in an elastic bandage also help to reduce the swelling and pain.

Surgical treatments are rarely needed in case of Baker’s cyst associated with the disease osteoarthritis. This type of cyst is improved with the treatment of arthritis. But if the Baker’s cyst is formed due to cartilage tear then surgery is needed to remove or reform the torn cartilage.

Arachnoid Cyst

When cerebrospinal fluid (colorless fluid present in the brain and spine) is covered by arachnoidal cells with collagen are called as arachnoid cysts. It is named as such, because it develops between the surface of the brain and the arachnoid membrane i.e., one of the three membranes that cover the brain and the spinal cord, or the cranial base. These are relatively common asymptomatic and benign lesions that actually are congenital disorder(birth defects). In most cases they begin during infancy, however, its onset usually occurs after adolescence.
Arachnoid cysts are found either on the brain or spine. The cysts in brain usually occur adjacent to the arachnoidal cistern and the cysts in spine can be extradural, intradural, or perineural (surrounding a nerve) and these have clear signs and symptoms as radiculopathy ( a condition in which one or more nerves are affected and do not work properly). The symptoms often occurs gradually and often depends upon the location of cyst which delays the diagnosis. If the cysts are small in size they have no signs and are discovered only by any incident, but if the size is large they have many symptoms which are described below.

  • Enlargement (increase in size) of the head (macrocephaly) in children
  • Headaches, such as migraine or tension type headache
  • Bobble head doll syndrome
  • Excessive accumulation of cerebrospinal fluid (hydrocephalus)
  • Increase in intracranial pressure
  • Seizures
  • Behavioral changes
  • Delay in development
  • Nausea
  • Weakness or paralysis on one side of the body (hemiparesis)
  • Lack of muscle control (ataxia)
  • Hallucination
  • Alzheimer’s disease
  • Urinary incontinence

 

 

The main cause of arachnoid cysts is actually not known. Mostly these are developmental deformities that appear due to congenital splitting of arachnoid membrane. They can be hereditary disorders. Its diagnosis is done by MRI and do not require treatment, but if these cysts are symptomatic then treatment is required, as it may cause permanent severe neurological damage. Following procedures are applied to remove the cyst.

  • Surgical treatment (resolve psychiatric manifestations)
  • Fenestration or excision
  • Capsular resection
  • Needle aspiration or burr hole
  • Endoscopic or laser-assisted techniques

Breast Cyst or Fibrocystic Breast

Any fluid filled sac within the breasts are the breast cysts. These cysts can feel like a lump, but actually this lump (cyst) is a small, harmless fluid-filled sac, not any cancerous lump of cells. One breast can have one cyst or many cysts that clump together. These are usually oval or round shape lumps with clear edges that may appear like water filled balloons or grapes, but in some cases breast cyst feels firm. They may develop naturally in the breasts with the age, because hormonal changes occurs in the body as the body gets old and causes changes in the breasts. Although it can develop at any age, but are most common in women at the age of 35 or more, because menopause occurs in this age which disturbs the hormones alot. After menopause these cysts may disappear, but if hormone therapy is done then they can reappear.

Breast cyst vary in size. It can range from a few millimeters to several centimeters. Many women can have cysts, but may not be able to feel them. Sometimes they can be uncomfortable and painful that need proper treatment. The pain is usually worse during pregnancy or in the second half of menstrual cycle. This discomfort may be alleviated by draining the fluid from the cyst.

Some signs and symptoms of breast cysts are as follows:

  •     Easily movable, smooth, round or oval lump with clear edges.
  •     Pain and tenderness in the cyst area.
  •     Clear , yellow or dark brown nipple discharge.
  •     During period the lump size increases and decreases as the period ends.

    Breast cysts are detected by help of mammograms (breast x-ray). However, physical examinations also play an important role in the diagnosis. But mammogram provides valuable and clear image of breast tissue. Breast cysts does not increase any risk of developing cancer and are mostly benign.