Bartholin gland cyst

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Bartholin gland cysts are located in the postero-lateral inferior third of the vagina and are associated with the labia majora.

Clinical presentation

Most patients are asymptomatic ⁴.

Complications

infection: may turn into Bartholin gland abscesses
rare instances of development of adenocarcinoma or squamous cell carcinoma within cyst ⁵

Pathology

Cysts form as a result of an obstruction of the gland's duct by a stone/ stenosis related to prior infection or trauma ⁶. Chronic inflammation can lead to ductal obstruction from pus or thick mucus which in turn can result in retained secretions within the Bartholin glands.

Radiographic features

~~General~~

They are typically seen as rounded unilocular cysts lying at the posterior aspect of the vagina. Their location is at or below the level of the pubic symphysis (best appreciated on coronal imaging).

Ultrasound

May only be demonstrated on transperineal ultrasound if the cyst is close to the labia.

MRI

Signal characteristics include:

T1: can be of variable signal
T2: often of uniform hyperintensity on T2-weighted imaging although can occasionally vary dependent on protein content, may also be heterogeneous when infected

Complications

~~infection: may turn into~~ ~~Bartholin gland abscesses~~
~~rare instances of development of adenocarcinoma or squamous cell carcinoma within cyst~~ ⁵

Treatment and prognosis

Infected or symptomatic cysts may require marsupialization.

Differential diagnosis

General imaging differential considerations include:

Bartholin gland abscess: may show associated inflammatory features
Bartholin gland tumour: consider if discovered in the post-menopausal patient
Gartner duct cyst: their location at or above the level of the pubic symphysis helps to differentiate them from Bartholin duct cysts.
Nabothian cyst: located at a much higher position within the uterine cervix
Skene duct cyst: centred more anteriorly and closer to the external urethral meatus, sagittal imaging may help differentiate in some cases
urethral diverticulum

-<p><strong>Bartholin gland cysts</strong> are located in the postero-lateral inferior third of the <a href="/articles/vagina">vagina</a> and are associated with the <a href="/articles/labia-majora">labia majora</a>. </p><h4>Clinical presentation</h4><p>Most patients are asymptomatic <sup>4</sup>.</p><h4>Pathology</h4><p>Cysts form as a result of an obstruction of the gland's duct by a stone/ stenosis related to prior infection or trauma <sup>6</sup>. Chronic inflammation can lead to ductal obstruction from pus or thick mucus which in turn can result in retained secretions within the Bartholin glands. </p><h4>Radiographic features</h4><h5>General</h5><p>They are typically seen as rounded unilocular cysts lying at the posterior aspect of the vagina. Their location is at or below the level of the pubic symphysis (best appreciated on coronal imaging).</p><h5>Ultrasound</h5><p>May only be demonstrated on transperineal ultrasound if the cyst is close to the labia.</p><h5>MRI</h5><p>Signal characteristics include:</p><ul>
~~-<li>~~
~~-<strong>T1:</strong> can be of variable signal</li>~~
~~-<li>~~
~~-<strong>T2:</strong> often of uniform hyperintensity on T2-weighted imaging although can occasionally vary dependent on protein content, may also be heterogeneous when infected</li>~~
~~-</ul><h4>Complications</h4><ul>~~
+<p><strong>Bartholin gland cysts</strong> are located in the postero-lateral inferior third of the <a href="/articles/vagina">vagina</a> and are associated with the <a href="/articles/labia-majora">labia majora</a>. </p><h4>Clinical presentation</h4><p>Most patients are asymptomatic <sup>4</sup>.</p><h5>Complications</h5><ul>
+</ul><h4>Pathology</h4><p>Cysts form as a result of an obstruction of the gland's duct by a stone/ stenosis related to prior infection or trauma <sup>6</sup>. Chronic inflammation can lead to ductal obstruction from pus or thick mucus which in turn can result in retained secretions within the Bartholin glands. </p><h4>Radiographic features</h4><p>They are typically seen as rounded unilocular cysts lying at the posterior aspect of the vagina. Their location is at or below the level of the pubic symphysis (best appreciated on coronal imaging).</p><h5>Ultrasound</h5><p>May only be demonstrated on transperineal ultrasound if the cyst is close to the labia.</p><h5>MRI</h5><p>Signal characteristics include:</p><ul>
+<li>
+<strong>T1:</strong> can be of variable signal</li>
+<li>
+<strong>T2:</strong> often of uniform hyperintensity on T2-weighted imaging although can occasionally vary dependent on protein content, may also be heterogeneous when infected</li>
~~-<a href="/articles/gartner-duct-cyst">Gartner duct cyst</a>: their location at or above the level of the pubic symphysis helps to differentiate them from Bartholin duct cysts.</li>~~
+<a href="/articles/gartner-duct-cyst">Gartner duct cyst</a>: their location at or above the level of the pubic symphysis helps to differentiate them from Bartholin duct cysts</li>

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