Diagnostic Ultrasound - Abdomen and Pelvis

Bartholin Cyst
Diagnoses: Female Pelvis
TERMINOLOGY
• Occlusion of Bartholin glands results in cyst formation
IMAGING
• Can be seen with all imaging modalities (CT, US, MR)
○ Usually found incidentally
• US: Cystic structure: Anechoic to mixed echogenicity if
complicated by hemorrhage or infection
○ May contain septations
○ Thick walled if infected
TOP DIFFERENTIAL DIAGNOSES
• Sebaceous cyst
• Thrombophlebitis/other infections/varices
• Hematoma, endometrioma
• Gartner duct cyst
• Skene gland cyst
• Malignancy
KEY FACTS
PATHOLOGY
• Usually asymptomatic
○ Superimposed infection can develop
– Increase in size; painful
• Malignancy very rare
○ Squamous and adenocarcinoma most common types
CLINICAL ISSUES
• Simple drainage can result in recurrence up to 38%
○ Incision/drainage ± silver nitrate cautery,
marsupialization or excision, placement of Word
catheter
DIAGNOSTIC CHECKLIST
• 1-4 cm cystic lesion located in vulvar vestibule, just lateral
and inferior to vaginal introitus
• Usually asymptomatic
(Left) Longitudinal ultrasound
shows an infected right
Bartholin cyst ſt, which
contains echogenic debris.
(Right) Longitudinal color
Doppler ultrasound of the
infected right Bartholin cyst
ſt shows surrounding
hyperemia st.
(Left) Transverse ultrasound
shows a hemorrhagic right
Bartholin cyst ſt in a patient
who presented with acute
pain but no signs of infection.
(Right) T2 MR shows the
typical location of Bartholin
cysts ſt, which are often an
incidental finding. Note the
high T2 signal from internal
fluid.
844