A nabothian cyst (or nabothian follicle) is a mucus-filled cyst on the surface of the cervix. They are most often caused when stratified squamous epithelium of the ectocervix (portion nearest to the vagina) grows over the simple columnar epithelium 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 or

cervical cap The cervical cap is a form of barrier contraception. A cervical cap fits over the cervix and blocks sperm from entering the uterus through the external orifice of the uterus, called the ''os''. Terminology The term ''cervical cap'' has been ...

, or when checking the cervix as part of

fertility awareness Fertility awareness (FA) refers to a set of practices used to determine the fertile and infertile phases of a woman's menstrual cycle. Fertility awareness methods may be used to avoid pregnancy, to achieve pregnancy, or as a way to monitor gyneco ...

. A

health care provider A health care provider is an individual health professional or a health facility organization licensed to provide health care diagnosis and treatment services including medication, surgery and medical devices. Health care providers often receive ...

may notice the cysts during a pelvic exam. Nabothian cysts are also incidentally found during MRI imaging. During the healing process of chronic

cervicitis Cervicitis is inflammation of the uterine cervix. Cervicitis in women has many features in common with urethritis in men and many cases are caused by sexually transmitted infections. Non-infectious causes of cervicitis can include intrauterine ...

squamous 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 intercellula ...

of ectocervix proliferates and enter the

cervical canal The cervical canal is the spindle-shaped, flattened canal of the cervix, the neck of the uterus. Anatomy The cervical canal communicates with the uterine cavity via the internal orifice of the uterus (or internal os) and with the vagina via the ...

(endocervix), covering and obstructing the columnar epithelium 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 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 Cryotherapy, sometimes known as cold therapy, is the local or general use of low temperatures in medical therapy. Cryotherapy may be used to treat a variety of tissue lesions. The most prominent use of the term refers to the surgical treatment, s ...

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 The Papanicolaou test (abbreviated as Pap test, also known as Pap smear (AE), cervical smear (BE), cervical screening (BE), or smear test (BE)) is a method of cervical screening used to detect potentially precancerous and cancerous processes in t ...

, in which case the clinician may puncture the cyst with a needle and drain it. If nabothian cysts occur with chronic

(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 Anatomy () is the branch of biology concerned with the study of the structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old science, having it ...

Martin Naboth (1675–1721), who wrote about them in a 1707 treatise titled ''De sterilitate mulierum''. However, they were earlier described by French surgeon Guillaume Desnoues (1650–1735). Since it is a derived term, nabothian is not spelled with a capital first letter.

References

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