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cyst

Disease name

Cyst is a benign disease, which can grow on the surface of the human body, but also in the internal organs; A cyst is a cystic benign mass that grows on the surface of the body or a certain organ in the body Contents Is liquid^[2] 。 Generally speaking, the common cysts are“ Renal cyst ”、“ Hepatic cyst ”, "simple oophoritic cyst ”And“ Chocolate cyst ”。 Renal cyst And divided into simple Solitary renal cyst and Polycystic kidney 。

Chinese name: cyst
Foreign name: cyst^[3]

Definition: A cystic benign mass growing on the body surface or inside an organ
Discipline: Medical Science

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pathogeny

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1. Congenital genetic

1. Hair Root sheath Cysts: past 114 degree lipocyst Autosomal dominant inheritance 。

2． steatocystoma multiplex : for Autosomal dominant inheritance 。

3． Dermoid cyst : It is congenital after birth.

4. Bronchogenic and thyrohyoid duct cysts are caused by congenital dysplasia.

5. Penile midline cyst is congenital dysplasia Caused by.

6. The cause of eruptive fimbriat cyst is unclear. Some reports believe it belongs to Autosomal dominant inheritance 。

II. Unidentity of cause

cyst

1. New fluid cyst.

2． Miliary papule ： Primary The reason is unknown secondary Most of them are found in epidermal giant scar lysis, congenital ectodermal defects Tardiness Cutaneous phyllosis Dermabrasion After.

3． Epidermal cyst : The reason is unknown.

differential diagnosis

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preface

Most cysts are round, protruding from the skin surface Semicircle 。 Usually located in the dermis and Subcutaneous tissue 。 Because Cyst wall Because of the wrapping, the edges are smooth and tidy, and there is little adhesion with the surrounding tissues, so the skin is smooth, elastic and cystic, and its surface skin is mostly free of inflammation, but it is normal skin color. General developments Limited locality will not cause local compression symptoms.

1、 In the dermis

New fluid cyst

Most women aged 40-50 Skin lesion It usually occurs on the dorsal side of distal finger joint, and is often single. About 3-15cm in size, it is translucent, smooth, soft, skin colored cyst fluid, with stellate fibroblasts scattered in it.

Miliary papule

More common in women of any age Primary The cause is unknown; secondary Most of them are caused by large scar epidermolysis, congenital ectodermal defects, Tardiness Karin's disease of skin Dermabrasion After. Primary skin lesions It usually occurs on the eyelid Zygomatic region ； Secondary patients are prone to auricle Back of hand, forearm. It is large and hard, and white when broken sebum Sample.

trichilemmal cyst

Used to call Sebaceous cyst Middle aged women are more common, and tend to hair on the head Epidermal cyst It is not easy to distinguish the latter, which is commonly seen in facial and neck dryness. The cystic wall of this disease is composed of squamous epithelium isthmus Cells are similar. The content of the cavity is Eosin Substance.

steatocystoma multiplex

It can occur in men and women of all ages. Skin lesion It usually occurs in the middle and lower part of the chest and scrotum single shot Or multiple, normal skin color or yellow, a few millimeters to 1-2 cm in diameter, soft, small ones slightly hard. The contents of the chamber are oil samples or cheese Shape.

Epidermal cyst

It is commonly seen in young people and children, and rarely seen in old people, with a diameter of 0.5-5cm, normal skin color, round and elastic, and slightly hard. The capsule wall is normal skin, and the capsule cavity is filled with keratin. It can be single or multiple, often occurring on the scalp, face, neck and trunk.

Bronchogenic and thyrohyoid duct cyst

Is congenital dysplasia More common in sternum Notch Upper neck front or foot. It occurs shortly after birth, and multiple single lesions are small, often accompanied by thin tubes. Both are similar in appearance, and the cyst wall is Pseudostratified columnar epithelium Composition, visible epithelial cells Ciliary process in human capsule.

Penile midline cyst

Congenital dysplasia is more common in young people and children. Skin lesion Located on the ventral side of the penis, especially glans The diameter of the center line is about several millimeters. The cyst wall is Pseudostratified epithelium Some epithelial cytoplasm is transparent.

Exanthematous senile hair cyst

Small follicular cysts, 1-2mm in size, are commonly seen in children and young people. The surface may have skin defects and Umbilicus fossa It is common in the chest and can also be seen in the limbs. The cystic wall of the back is squamous epithelium, and the cystic cavity is lamellar keratin and hair. The follicle wall is concave to form a hair follicle like structure.

2、 At Subcutaneous tissue

cyst

Dermoid cyst : After birth, there are multiple single shots. Skin lesions are often located around the eyes and the midline of the abdomen and back of the face, and can occur everywhere on the body surface. The cyst wall with a diameter of no more than 2 cm is composed of Stratified squamous epithelium Composition, but with Epidermal cyst Different. The follicle cavity contains various epidermal appendages such as hair, and hair follicles with hair protrude into the cavity.

Chocolate cyst Also called "ovary" Endometriosis ”In other words, this is endometrium "Run" to the inside of the ovarian tissue, and periodic bleeding occurs simultaneously with the uterus. These old blood, accumulated over time, has become chocolate like color, so it is called chocolate cyst.

therapeutic method

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There are three main treatment methods for cysts:

1、 It is the traditional method of cutting the cyst, that is, fenestration and drainage or peeling treatment of the cyst. This method has the advantages of long incision, more bleeding, heavy trauma, high cost and easy recurrence.

2、 Yes laparoscope Although the incision of cyst is only a hole and the wound is much smaller than that of incision, it still needs to be hospitalized and the cost is not small. This is a last resort.

3、 This method uses needles instead of knives, which is magic rather than myth. This technology is widely used, such as Ultrasound intervention The application of technology in the field of genetics can B-mode ultrasonography Fetal removal under direct vision Umbilical cord blood , Get amniotic fluid Take embryo villus samples. You know, fetuses umbilical cord The caliber is very small, only 6-8mm. It can be punctured under the guidance of ultrasound. For cysts several centimeters and more than ten centimeters in size, the success rate of puncture can reach 100%. Since the advent of this technology, many patients have suffered Polycystic liver 、 Polycystic kidney Patients with hereditary cyst diseases that are easy to recur have avoided the pain of laparotomy.

① The traditional laparotomy, fenestration and drainage, and cyst dissection are the most worrying Recurrence rate High, such as polycystic kidney Hereditary disease The root of the disease is located in the gene position, and it is impossible to solve the problem with surgery. So the recurrence rate is over 60%.

② And because of the capsule Parietal cell The common feature of Columnar cell 。 This columnar cell grows vigorously and has a strong secretory function, so it is difficult to remove it completely. As long as a little cell is left, it will germinate like a seed, and the cyst will recur.

③ And Ultrasound Interventional Therapy This new technology is to make up for the shortcomings of traditional surgery for cysts. Experienced doctors can accurately aim at the cyst target under the guidance of B-ultrasound image. Use fine acupuncture Enter the cyst, suck out the fluid in the cyst, inject sclerosing drugs into the cyst wall, destroy the columnar cells with strong secretion, so as to prevent the recurrence of the cyst.

common sense

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Renal cyst It is a kind of water tumor of the kidney. When the cyst gradually increases, the normal renal tissue is being eroded. At this time, the patient will have low back pain, and the pain will radiate to the bladder. Symptoms associated with severe pain include: Chest tightness , nausea, sweating vertigo 、 hematuria Etc.

Traditional Chinese medicine believes that this disease is due to Qi stagnation and blood stasis , wet and turbid, accumulation caused by evil blood stasis. Qi blood disharmony or emotional disorder caused by long illness, Stagnation of liver qi Over time, qi and blood stagnate, and Damp heat Retained coke, Bladder gasification Loss of responsibility leads to illness.

Main symptoms

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1． proteinuria : Generally, the amount is not much, and it will not exceed 2g in 24-hour urine. More will not happen Nephrotic syndrome 。

2． hypertension : The solid cyst compresses the kidney, causing renal ischemia renin Increased secretion causes hypertension. stay renal function When normal, more than 50% of patients have hypertension, and when renal function declines incidence rate Higher.

3. Renal function decline: due to the space occupying and compression of cysts, the normal renal tissue is significantly reduced, and the renal function is progressively decreased.

4. Too much sex Kidney asthenia And the decline of renal function, ranging from redness and inflammation of individual cysts to itching and inflammation of systemic cysts. Attention should be paid to rest, fitness and recuperation, and sex should not be too frequent.

complication

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spontaneity Infection in Simple renal cyst It is rare, but once it happens, it is difficult to be the same Renal carbuncle identify. Sometimes, the cyst can bleed. When it happens suddenly, it can cause severe pain. The bleeding can come from the accompanied cancer on the cyst wall. The cyst is located at the lower pole of the kidney and is close to ureter Can be aggravated Hydronephrosis , and urine Renal pelvis The pressure of can cause back pain. This obstruction can also lead to kidney infection.

Introduction of perianal cyst

Anal canal , perirectal soft tissue Acute disease occurs in or around the space Suppurative infection , and form abscess , called anal canal Perirectal abscess 。 It is characterized by spontaneous ulceration or anal fistula often formed after surgical incision and drainage. It is a common anorectal disease, also known as anal canal Proctitis disease Pathological process Of acute stage ， Anal fistula It's chronic.

Introduction to uterine cysts

Uterine cyst It is a rare disease and is easily ignored clinically. It can be divided into congenital and acquired Uterine cyst , the former comes from Mesonephric duct and Accessory mesonephric duct , mostly in the back wall or the bottom of the uterus; The latter is mostly secondary to benign diseases or Serous membrane Of Interstitial cell Developed from, including fibroid Cystic change Adenomyoma of uterus 、 Cervical retention cyst And uterine serous cysts.

treatment cervix Gland cyst is not difficult. It is generally necessary to check which bacterial infection is caused cervicitis After the inspection is clear, the corresponding treatment will be given for the infection. For cysts that are not suitable for regression, they can be punctured first, and then burned by laser, freezing and other methods. Generally, treatment will not affect fertility, but it will affect if scar is formed on the cervix Natural childbirth 。

Introduction to ovarian cyst

oophoritic cyst It refers to the formation inside or on the surface of the ovary tumor 。 The substance in the mass is usually liquid, sometimes solid, or a mixture of liquid and solid. oophoritic cyst Is usually small, similar to peas or cashew So big, some cysts look like Softball Same, or even larger.

Ovarian cysts are a common phenomenon. Most cysts are caused by changes in the normal function of the ovary, so most of them oophoritic cyst They are all benign. But if the nature of the cyst changes, it will become oophoroma 。 The treatment should be based on your age, symptoms, size of myoma, size of cyst, fertility and general health. The following differences are generally adopted Treatment measures 。 yes myoma The uterus of women less than 8 weeks of pregnancy, without obvious symptoms or near menopause is smaller than 12 weeks of pregnancy, normal, and without compression symptoms can be observed temporarily. Follow up every 3 months. Generally, after menopause, myoma may gradually shrink. When myoma increases or symptoms are obvious during follow-up, it should be considered surgical treatment 。 Long term Conservative treatment Invalid, or obvious symptoms, larger myoma, combined anemia And those with rapid growth should consider treatment.

Cervical cyst It is mainly caused by its formation and“ whelk ”Similar, in cervical erosion During healing, the new squamous epithelium covers Cervical gland The mouth of the gland tube is blocked by extending into the gland tube; Periductal connective tissue Hyperplasia or scar It compresses the glandular duct, narrows or even blocks the glandular duct, obstructs the drainage of gland secretions, and forms a cyst called Neumann's cyst of cervix 。

stay Chronic cervicitis The cervical glands and surrounding tissues proliferate. When the gland tube is squeezed by the surrounding tissues and the gland mouth is blocked, the secretions in the gland body cannot flow out and remain inside, causing the gland cavity to expand, forming cystic tumors of different sizes, called“ cervix Gland retention cyst Nabot cyst 。 The mucus contained in it is usually clear and transparent, but may be turbid and purulent due to combined infection. Cysts are generally small and scattered, and may protrude cervix Surface. The small ones are only small grains of rice, and the large ones can reach Corn grain Large, bluish white, possibly accompanied by erosion, but also common in smooth surface cervix 。 because chronic inflammation Long term stimulation of, recurrent congestion and edema of cervical tissue, Inflammatory cell Infiltration and connective tissue hyperplasia lead to hypertrophy of the cervix, which can be more than twice as large as the normal cervix in serious cases. Severe inflammation can lead to Abnormal menstruation even to the extent that Infertility 。

Precautions for patients with hepatic cyst

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1． Hepatic cyst Most are congenital, some are single, some are multiple, and some are combined Renal cyst Generally speaking, liver cysts are right human health Without much influence, the patients need not be nervous.

2. Multiple small cysts B-mode ultrasonography or CT examination Sometimes they find more, sometimes they find less. That's because of the limitations of the inspection equipment or the different levels of carefulness of the inspectors. It's not surprising that one less does not mean good, and one more does not mean bad.

3. Too large Hepatic cyst The needle can be used for those with compression symptoms or inflammation to the liver itself or surrounding organs Aspirate The fluid in it may grow again in the future. You can also operate to open the cyst to relieve pressure. Inflammatory Hepatic cyst It can be left untreated and there is no medicine to treat - because there is no need for treatment.

4. B-ultrasound or CT diagnosis Hepatic cyst It is very reliable and generally does not need to do more inspections.

5. Can work, can exercise, there is nothing to pay special attention to in life.

6. No hepatic cyst canceration You can rest assured.

7． Hepatic cyst Do not drink and smoke less. Because smoking has an impact on the lungs, patients must remember not to drink and smoke less.

How big is the common cyst?

Hepatic cyst Sometimes the patient is accompanied by other visceral cysts, such as Renal cyst 、 Pulmonary cyst And occasionally pancreatic cyst Splenic cyst Etc. Polycystic liver The liver can be covered with cysts of. The cyst can be single, just one, as small as 0.2 cm; It can also be as many as ten or dozens, and even one can be as large as tens of centimeters.

Hepatic cyst It grows slowly, so it may be asymptomatic for a long time or lifetime clinical manifestation It also depends on the position, size and number of cysts, whether there is compression on adjacent organs and whether there is complication Different. Hepatic cyst Generally, there are no symptoms. When the cyst grows to a certain extent, it may compress the gastrointestinal tract and cause symptoms, such as abdominal discomfort and fullness; Hepatic cyst The common complications are bleeding, bacterial infection, fistula and penetration, but rarely canceration 。

along with Image Diagnostics The development and popularization of B ultrasound, especially, has been listed as one of the routine physical examination of the population Hepatic cyst Of Detection rate It can reach 98%, so many patients are found with this disease. However, when comprehensively understanding the size, number and location of cysts, as well as the liver and related organs around the liver surgical treatment Of Hepatic cyst For patients, CT examination is obviously superior to B ultrasound in guiding surgery.

Sometimes in order to make a differential diagnosis, it is still necessary to do some blood tests, especially blood Alpha fetoprotein (AFP) check to exclude Primary liver cancer 。

Is liver cyst serious?

Hepatic cyst is a benign and congenital disease. To say it is benign is to say it is not tumour , two are not cancer It will not become cancerous. It is a "small water ball" in the liver. The wall of the ball is epithelial cells, and water is in the ball. The epithelial cells produce water, which makes the water ball become larger and larger. It is said that it is congenital, not that it begins to grow cysts after birth. Most of them grow up in adulthood or old age.

The number of hepatic cysts can vary from one to thousands（ Polycystic liver ）。 Cysts can be large or small, some very small, only a few millimeters; Some are the size of soybeans, Grape Size, egg size; Some can be as large as more than 20 cm.

Most cysts have no effect on human body and liver because they are very small. But when the cyst is longer and bigger, the longer and more, symptoms will appear. When the cyst is more than 10 cm long, compression symptoms may appear, such as compression of stomach and intestines Epigastrium Sense of fullness; oppression Diaphragm Affect breathing; Cystic compression of the hepatic hilum bile duct Can appear jaundice ； Polycystic liver compression causes less and less normal liver tissue, liver function Affected.

Symptoms of cervical cysts

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Cervical cyst Yes chronic cervicitis The main symptom of chronic cervicitis is the increase of leucorrhea Pathogen The color and quantity of leucorrhea are different. Leucorrhea can be viscous or purulent, sometimes with bloodshot or a small amount of blood, or Contact bleeding 。 Pain often occurs in the lower abdomen or lumbosacral region, and falling pain or dysmenorrhea , often in menstruation Phase, defecation or sexual intercourse, in addition Irregular menstruation and Infertility 。

Clinical manifestation of cervical cyst: during examination, multiple bluish white protrusions of different sizes can be seen on the surface of the cervix Vesicle (Not purple), containing mucus. The small ones are as big as rice grains, and the large ones are Corn grain Large, some can grow very large, protruding from the surface of the cervix, or even reaching orificium vaginae The root is connected with the cervical pedicle, often with Cervical hypertrophy 。

Diagnosis and treatment of perianal cysts

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Perianal Subcutaneous abscess Most common, mostly caused by Anal gland Infection outside physiological sphincter The lower part of the skin spreads outward or directly outward.

1、 Diagnostics

1. Symptoms

(1) Most of them have acute onset.

(2) There is swelling and pain around the anus and rectum, and pus flows after ulceration.

(3) May be accompanied by Aversion to cold and fever ， headache , fatigue, Anorexia etc. Systemic infection Sexual symptoms.

(4) It may be accompanied by difficulty in urinating and defecating.

2. Physical signs

(1) Perianal redness and swelling on visual examination, tumor Higher than leather.

(2) Finger examination shows that the anorectal region is hot, tender or tender, with wavy sensation or hard mass, or the rectal mucosa is full, and the anal temperature is higher than normal.

(3) Anoscopy was performed to observe whether there were internal orifice, pus, blood and other lesions in the rectum.

3. Differential diagnosis

(1) Perianal Folliculitis 、 furuncle

It tends to occur under the skin around the anus, due to Anal recess nothing Pathological Connection will not be formed after breaking Anal fistula 。

(2) Paraanal Sebaceous cyst

Paraanal mass, but no skin Redness and swelling And tenderness, smooth and round surface, clear edge, no systemic symptoms. Redness and swelling may also occur after cyst infection Febrile pain However, no anal fistula is formed after ulceration.

2、 Treatment

General treatment principles

When the pus is not formed, anti infection treatment is mainly used, supplemented by external use of Chinese medicine. abscess Once it is formed, it should be cut and drained in time to prevent the infection from spreading to the deep and surrounding tissues.

Preventive measures for perianal cysts

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(1) Pay attention not to eat or eat less spicy and stimulating food, such as pepper, wine, greasy goods, etc. In summer, we should pay attention to easy digestion and rich nutrition, eat more vegetables, and not eat spoiled food to prevent Intestinal infectious disease 。

(2) Pay attention to rest, prevent excessive fatigue, and strengthen the body Resistance 。 Eat more in summer watermelon It can not only relieve heat, but also replenish body fluid, prevent constipation, so as to achieve prevention Perianal abscess The purpose of.

(3) Pay attention to the sanitation of the anus, change your underwear frequently, and clean the anus after defecation.

(4) Active treatment and Perianal abscess Related diseases, such as diabetes 、 tuberculosis 、 Anal sinusitis Etc. If there is any discomfort in the anus, go to the hospital as soon as possible and use medicine under the guidance of the doctor.

Which symptoms are easily confused with cysts

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1. Sacrum bone cyst Osseous Neoplastic lesion , also known as Solitary bone cyst Simple bone cyst. Cyst wall It is a fibrous capsule with yellow or brown liquid inside.

2． Ureterocele Ureteral cyst: cystic dilatation of the end of the ureter. embryonic development Stage ureter and Urogenital sinus The diaphragm between them is not absorbed and subsides, forming Ureteral orifice Different degrees of stricture can also be caused by factors such as weak fiber structure at the end of the ureter or too long and curved course of the intermural segment, which forms cystic dilatation and protrudes into the bladder after the impact of urine flow.

3． mediastinum Cyst of mediastinum is a kind of mediastinal masses, which is classified as Mediastinal tumor (mediastinal tumor), but many people advocate describing it separately from mediastinal tumor.

Dietary advice

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^[1] First, Hepatic cyst Patients should eat more High quality protein High food. But pay attention to the supplement of high fiber, high vitamin food and low-fat food. In the diet of liver cysts, patients with liver cysts should ensure that they are not partial to food, Grains , fresh vegetables and fruits, cattle, sheep, pigs lean meat , eggs, milk, fish and shrimp can be eaten.

Second, patients with liver cysts should eat more Red vegetable The key recommended diet for liver cysts is Carrot 、 Tomatoes , Red Jujube 、 pitaya Vegetables and fruits with equal red color. In addition, patients with liver cysts need to drink more water. Drinking more water can enhance blood circulation, promote metabolism, and also promote glands, especially Digestive gland and Pancreatic juice 、 bile Secretion of.

Third, patients with liver cysts should not drink alcohol and eat less spicy fried food , as well as sweet food; It is also forbidden to blindly supplement, and do not trust the supplements advertised at will, so as not to damage the liver or increase the burden on the liver.

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