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cyst

Divided  into

1-True cyst :is lined by epithelium or endothelium , if infection supervenes, the true lining may be destroyed and replaced by granulation tissue ; the fluid usually serous or mucoid and varies from brown staining by altered  blood to almost colorless , in epidermoid ,dermoid and branchial cysts the contents like porridge or toothpaste ; as a result of shedding of sequamous cell ,cholesterol crystals are after found in the fluid of branchial cyst.  

2-False ( Pseudocyst ) :certain collection of fluid are not regarded as true cysts. They are usually exudation and degeneration cysts. A pseudo-cysts of the pancreas is an encysted collection of fluid in the lesser sac. In tuberculous peritionitis fluid may be walled off in cysticform by adherent coils of interstine. Fluid may collect in the center of a tumour      ( cystic degeneration ), due to haemorarrhage or necrosis. This can also happen in the brain as a result of ischaemia.  

Classification 

Congenital   

Sequestration  dermoid e.g ( dermoid cyst & branchial )

Tubuloembryonic cyst of embryonic remnant e.g ( Thyroglossal cyst )  

Cyst of embryonic remnants like cyst of genital and urinary systems e.g ( congenital cystic kidneys or hydatid of morgagni )

Acquired

Retention : due to accumulation of secretion of gland due to obstruction of the duct e.g  pancreas, paroted, breast. epididymis bartholin’s gland and sebaceous cyst ( epidermoid cyst )

exudation : when fluid exudes into an anatomical space already lined by endothelium e.g ( hydrocele, a bursa )  

distention : ( like thyroid cyst due to dilatation of acini or in the ovary )

cyst tumors  implantation  dermoid  : cystic teratomas     ( dermoid cyst of the ovary )

Trichniasis  

 3- Cystcercosis

Clinical features 

Swelling usually has smooth ,spherical appearance ; fluctuation depends upon the presence of fluid within , tense cyst feels like solid tumour ; carful palpation between two fingers may elicit  a  characteristic elasticity ,  

although , a solid tumor is most harder at the centre ,cyst less hard, cyst may be confused with cold abscess or lipoma if  fluctuant  ,cold abscess usually has a peculiar rim of thickening surrounding the soft centre  Trasillumination , brilliantly clear cyst contains  serous fluid , can’t be distinguished  from lipoma or dermoid cyst or branchial cyst

Although  U\S ,CT , aspiration  or excision reveal the true nature of the swelling  

Cyst may be painful especially  when infection  or hemorrhage inside causes  sudden increase in the intracystic tension  

Effect are according to site and size as with benign tumors , a cyst may compress ducts or blood vessels  as the main bile duct may be obstructed by cheledocal cyst

Complications of the cyst 

Infection : may followed by abscess  discharge on the surface forming ulcer or sinus  

Hemorrhage 

Torsion 

Calcification