A nabothian cyst (or nabothian follicle) is a mucus-filled cyst on the surface of the

cervix The cervix or cervix uteri (Latin, 'neck of the uterus') is the lower part of the uterus (womb) in the human female reproductive system. The cervix is usually 2 to 3 cm long (~1 inch) and roughly cylindrical in shape, which changes during ...

. They are most often caused when

stratified squamous epithelium A stratified squamous epithelium consists of squamous (flattened) epithelial cells arranged in layers upon a basal membrane. Only one layer is in contact with the basement membrane; the other layers adhere to one another to maintain structural i ...

of the ectocervix (portion nearest to the vagina) grows over the

simple columnar epithelium Simple columnar epithelium is a single layer of columnar epithelial cells which are tall and slender with oval-shaped nuclei located in the basal region, attached to the basement membrane. In humans, simple columnar epithelium lines most organ ...

of the endocervix (portion nearest to the uterus). This tissue growth can block the cervical crypts (subdermal pockets usually 2–10 mm in diameter), trapping cervical mucus inside the crypts.

Presentation

Nabothian cysts appear most often as firm bumps on the cervix's surface. A woman may notice the cyst when inserting a

diaphragm Diaphragm may refer to: Anatomy * Thoracic diaphragm, a thin sheet of muscle between the thorax and the abdomen * Pelvic diaphragm or pelvic floor, a pelvic structure * Urogenital diaphragm or triangular ligament, a pelvic structure Other * Diap ...

or cervical cap, or when checking the cervix as part of fertility awareness. A health care provider may notice the cysts during a pelvic exam. Nabothian cysts are also incidentally found during MRI imaging. During the healing process of chronic cervicitis, squamous epithelium of ectocervix proliferates and enter the cervical canal (endocervix), covering and obstructing the

columnar epithelium Epithelium or epithelial tissue is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. It is a thin, continuous, protective layer of compactly packed cells with a little intercellular ...

of endocervical glands. Thus, retention of mucus in the endocervical glands causes cyst formation. The size of the cyst may vary from a few millimetres to 4 cm in diameter.

Diagnosis

If a cyst has an unusual appearance, a

colposcopy Colposcopy ( grc, κόλπος, kolpos, hollow, womb, vagina + ''skopos'' "look at") is a medical diagnostic procedure to visually examine the cervix as well as the vagina and vulva using a colposcope. The main goal of colposcopy is to prevent c ...

will be performed to rule out other diagnoses. If the blood vessels are short, comma-like or corkscrew-shaped and bleed on contact, then the cyst may be a very rare mucin-producing carcinoma of the cervix. Magnetic resonance imaging is used to distinguish cancer from the typical nabothian cyst. T1-weighted MRI imaging would show intermediate to high intensity while T2-weighted imaging would show high signal intensity. Findings of solid components separating multiple cysts would be suggestive of adenoma malignum (a form of cervical cancer).

Treatment

Nabothian cysts usually require no treatment and frequently resolve on their own. Cryotherapy has been used to treat nabothian cysts but is rarely necessary. Very rarely a cyst may be so large that it prevents a clinician from performing a pap smear, in which case the clinician may puncture the cyst with a needle and drain it. If nabothian cysts occur with chronic cervicitis (inflammation of the cervix) then the underlying cause of the inflammation must be treated.

Eponym

Nabothian cysts are also known as nabothian follicles, mucinous retention cysts, or epithelial inclusion cysts. They are named after German anatomist Martin Naboth (1675–1721), who wrote about them in a 1707 treatise titled ''De sterilitate mulierum''. However, they were earlier described by French

surgeon In modern medicine, a surgeon is a medical professional who performs surgery. Although there are different traditions in different times and places, a modern surgeon usually is also a licensed physician or received the same medical training as ...

Guillaume Desnoues (1650–1735). Since it is a derived term, nabothian is not spelled with a capital first letter.

References

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