El-Agwany Ahmed Samy
Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
J Med Ultrasound. 2018 Jul-Sep;26(3):153-156. doi: 10.4103/JMU.JMU_38_18. Epub 2018 May 7.
Cervical nabothian cysts are common in women of reproductive age. Although cysts are generally small and asymptomatic, large ones are extremely rare and may be misdiagnosed as malignancy.
We report a case of large multiple complex nabothian cyst, which was suspected as malignant one on imaging and examination. Pelvic examination and ultrasonography revealed ballooned cervix with multiple large complex nabothian follicles. There was an associated large adnexal mass with ascites. The patient was treated with total hysterectomy and omentectomy after aspiration of the fluid from the cervical cysts for debulking and limiting complications. Pathology revealed granulosa cell ovarian tumor, omental panniculitis, and cervical nabothian follicles.
Large nabothian cysts should be kept in mind for differential diagnosis of cervical tumors. Ultrasonography is of value for the diagnosis of giant nabothian cysts and can aid in exclusion of malignancy. Differentiation between a malignant cystic lesion, such as an adenoma malignum, and a benign cystic lesion is crucial but difficult. Cervical nabothian follicles can be multiple and attain a large size up to 4 cm each. It is commonly benign but we should keep in mind the rare adenoma malignum on imaging and histopathology.
宫颈纳氏囊肿在育龄女性中很常见。虽然囊肿通常较小且无症状，但大的囊肿极为罕见，可能被误诊为恶性肿瘤。
我们报告一例巨大多发性复杂性纳氏囊肿病例，在影像学检查和体格检查中被怀疑为恶性。盆腔检查和超声检查显示宫颈呈气球样，有多个巨大的复杂性纳氏卵泡。伴有一个大的附件包块及腹水。在从宫颈囊肿抽吸液体以减少瘤体大小并限制并发症后，患者接受了全子宫切除术和大网膜切除术。病理检查显示为颗粒细胞瘤、网膜脂膜炎和宫颈纳氏卵泡。
对于宫颈肿瘤的鉴别诊断，应考虑到巨大纳氏囊肿。超声检查对于诊断巨大纳氏囊肿有价值，有助于排除恶性肿瘤。区分恶性囊性病变（如恶性腺瘤）和良性囊性病变至关重要但也很困难。宫颈纳氏卵泡可以是多发性的，每个大小可达4厘米。它通常是良性的，但在影像学和组织病理学检查中，我们应牢记罕见的恶性腺瘤。
