Bartholin gland cyst

Changed by Daniel J Bell, 9 Dec 2019

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Bartholin gland cysts ~~are located~~ (sometimes shortened to Bartholin cysts) are cysts of the Bartholin gland, found in the posterolateral 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 the 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

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

Treatment and prognosis

Infected or symptomatic cysts may require marsupialization.

History and etymology

The Bartholin glands are named after the Danish anatomist Caspar Bartholin the Younger (1655-1738), who made the first detailed study of their physiology and anatomy in humans ⁷.

Differential diagnosis

General imaging differential considerations include:

Bartholin gland abscess: may show associated inflammatory features
Bartholin gland tumour: consider if discovered in the postmenopausal 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 posterolateral 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>
+<p><strong>Bartholin gland cysts</strong> (sometimes shortened to <strong>Bartholin cysts</strong>) are cysts of the <a href="/articles/bartholin-glands">Bartholin gland</a>, found in the posterolateral 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>
~~-<li>rare instances of development of adenocarcinoma or squamous cell carcinoma within cyst <sup>5</sup>~~
+<li>rare instances of development of adenocarcinoma or squamous cell carcinoma within the cyst <sup>5</sup>
~~-</ul><h4>Treatment and prognosis</h4><p>Infected or symptomatic cysts may require marsupialization.</p><h4>Differential diagnosis</h4><p>General imaging differential considerations include:</p><ul>~~
+</ul><h4>Treatment and prognosis</h4><p>Infected or symptomatic cysts may require marsupialization.</p><h4>History and etymology</h4><p>The Bartholin glands are named after the Danish anatomist <strong>Caspar Bartholin the Younger</strong> (1655-1738), who made the first detailed study of their physiology and anatomy in humans <sup>7</sup>.</p><h4>Differential diagnosis</h4><p>General imaging differential considerations include:</p><ul>

References changed:

7. Hill RV. The contributions of the Bartholin family to the study and practice of clinical anatomy. (2007) Clinical anatomy (New York, N.Y.). 20 (2): 113-5. <a href="https://doi.org/10.1002/ca.20355">doi:10.1002/ca.20355</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/16795028">Pubmed</a> <span class="ref_v4"></span>

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