follicular cyst
Introduction
Introduction to follicular cyst Follicular cysts are formed by follicular epithelial degeneration, thickening of connective tissue in the follicular wall, death of egg cells, and unabsorbed or increased follicular fluid. Follicular cysts generally have no symptoms, and are accidentally found during gynecological examination or cesarean section. The cysts naturally absorb and resolve after 4 to 6 weeks. In some cases, due to the secretion of estrogen from the persistent follicle, the endometrial hyperplasia is caused, and the vaginal bleeding after menopause can cause pseudo precocious puberty in young girls. basic knowledge The proportion of the disease: the incidence rate of women is about 0.01% - 0.03% Susceptible people: women Mode of infection: non-infectious Complications: acute abdomen
Cause
The cause of follicular cyst
Physiological factors (25%)
It may be due to the secretion of follicle stimulating hormone in pituitary gonadotropin or even the imbalance between follicle stimulating hormone and luteinizing hormone, so that the mature follicle does not ovulate and grows continuously or the follicular degeneration is incomplete. The granulosa cells still secrete liquid to form cysts.
Disease factor (20%)
Ovarian congestion due to various conditions, such as chronic pelvic inflammation, ovarian sag, causing ovarian blood flow disorders, thickening of the tunica albuginea, so that mature follicles can not rupture ovulation, the endocrine fluid retention of the bubble to form a cyst.
Damage factor (15%)
As the follicular layer of blood vessels suddenly ruptures for some reason, the blood enters the follicular cavity to form follicular hematoma, the hematoma gradually absorbs, the blood cell components melt away, and the fluid increases and remains to form a cyst.
Maternal factor (10%)
Fetus, newborn are affected by placental secretion of hormones and maternal hormones.
Pathogenesis:
1. The morphology of the ovary is smooth or the cyst is bulged, single or even multiple, located in or below the cortex. The diameter of the cyst is rarely more than 4cm, rarely 7-8cm, the wall is thin, the cavity surface is smooth, grayish white or dark purple. The cystic fluid is watery or bloody.
2. Histomorphic sac wall consists of several layers of granulosa cells and peripheral ovarian membrane cells, both of which can be lightly flavinated. Granular cells can form call-Exner bodies. As the vesicle fluid increases, the vesicle wall is gradually compressed. Degraded, only a layer of flat granulosa cells and glassy-like follicular cells remain, and histologically often diagnosed as simple cysts.
Prevention
Follicular cyst prevention
Follicular cysts can occur in women of childbearing age, especially in menopause or peri-menopausal women, as well as in fetuses or women after 7 years of menopause. Ultrasound monitoring of the abdomen is performed regularly to observe the follicular condition. Once abnormal performance is found, other related examinations, such as six sex hormone tests and tumor marker examinations, should be considered.
Complication
Follicular cyst complications Complications
1. Ovarian cyst pedicle torsion: The pedicle of the ovarian tumor is composed of the pelvic funnel ligament, the ovarian intrinsic ligament and the fallopian tube. After acute torsion, the venous return is blocked, the tumor is highly congested or the blood vessels are ruptured, resulting in a sharp increase in the tumor, intratumoral hemorrhage, and finally the arterial blood flow is blocked. The tumor necrosis becomes purple-black, easily broken and secondary infection.
2. Ovarian tumor torsion: occurs along the direction of the pedicle, either clockwise or counterclockwise. If the twist is very light, there is a possibility of natural relaxation. This explains why some patients have had a history of recurrent abdominal pain. If the torsion cannot be recovered, the vein in the tumor pedicle is first pressed. At this time, the venous blood cannot flow back and the artery continues to supply blood, causing the tumor to become congested and swollen, resulting in exudation.
Symptom
Follicular cyst symptoms Common symptoms Postmenopausal bleeding Follicular cyst precocious
Follicular cysts generally have no symptoms. Occasionally, they are found by gynecological examination or cesarean section. The cysts are naturally absorbed and regressed after 4 to 6 weeks. In some cases, endometrial hyperplasia is caused by persistent follicle secretion of estrogen. Postmenopausal vaginal bleeding In young girls can cause pseudo precocious puberty, Strickler (1984) reported a case of 61 years old, 6 years of menopause, breast enlargement, tenderness, elevated blood estradiol, surgery found left ovarian follicular cyst, intrauterine Membrane hyperplasia is too long.
Examine
Examination of follicular cysts
Hormone level test: determine the body's sex hormone levels to understand female endocrine function and diagnose diseases associated with endocrine disorders. Commonly used sex hormones are follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), pregnancy Ketone (P), testosterone (T), prolactin (PRL).
Other auxiliary examinations: histopathological examination, tumor marker examination. Abdominal B ultrasound.
Diagnosis
Diagnosis and differentiation of follicular cyst
diagnosis
According to clinical manifestations, signs and above can be used to make a diagnosis, fetal, neonatal vesicular follicles and follicular cysts. The former is defined as follicle diameter 0.5 to 1 cm, and the latter is greater than 1 cm.
Differential diagnosis
1. Cystic granulosa cell cystic granulosa cell tumor is composed of a single granulosa cell, the cell is proliferative, and the mitotic figures are easy to see, which is significantly different from the degeneration of the disease cells.
2. Chlamydial corpus luteum granulosa cells and ovarian follicular cells are significantly flavinated, and the yellow flower ring structure is preserved at the edge, which is caused by pregnancy and is different from flavin follicle cyst.
