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Aim To illustrate the MDCT features of hepatic paragonimiasis and correlate the results with clinicopathological findings. Materials and methods Eighteen patients (8 male, 10 female; mean age 37years) with hepatic paragonimiasis were included in this study. MDCT features of their hepatic lesions were retrospectively reviewed and correlated with clinicopathological findings. Results All patients were lifelong residents in endemic areas of paragonimiasis, especially Paragonimiasis skrjabini variety. Abdominal pain or discomfort, fever and high eosinophil percentage were the predominant clinical features. In total, 21 lesions were detected on MDCT images, 18 (85.7%) directly contacted the hepatic capsule and 3 (14.3%) were adjacent to the capsule. Segment V (26%), VIII (26%) and VI (18.5%) were the most commonly involved sites. Sixteen lesions (76%) were conglomerated cystic or multilocular and 5 (24%) were solid. On plain MDCT scan, the margin and internal detail of the lesions were not clear except for one cystic variety, while they were clearly demonstrated on enhanced images. Single or multiple cysts with different diameters were commonly detected in the non-solid lesions, and some of them were mutually connected with tortuous tract formation. Among the solid lesions, 2 and 3 showed tubular and homogeneous enhancement, respectively. Conclusion Peripherally distributed lesions, mutually connected cysts with tortuous tract formation, and tubular enhancement, which may be closely associated with the infection route and migration of the worm, could be seen as the main MDCT features of hepatic paragonimiasis.

Diffusely enlarged thyroid glands (goitres) are becoming increasingly infrequent. However, in some geographical areas they are still relatively common and can cause compressive symptoms involving the trachea, oesophagus, and recurrent laryngeal nerve. Surgical treatment of diffusely enlarged thyroid glands requires a high level of expertise and may lead to severe complications. Here we present a case report of surgical treatment of an extremely enlarged thyroid gland, found in a 61-year-old female patient. The patient underwent surgery, and a thyroidectomy was performed. The resulting specimen weighed 4.7 kg (10.4 lbs). Histopathological examination revealed a multinodular goitre with multiple cysts and areas of haemorrhage and necrosis. Surgical excision can immediately resolve local symptoms and is often recommended when substernal extension is evident. To the best of our knowledge, this is the largest thyroid gland ever reported in the literature. Only experienced surgeons should treat large thyroid goitres. Ideally, large thyroid goitres should be treated before they reach a substernal component, otherwise any sudden growth in gland size could seriously compromise respiration.

A 39-year-old woman presented with right-sided pneumothorax. Partial lung resection was done via thoracoscopy. Five years later, left-sided pneumothorax occurred, and she underwent thoracoscopy again. However, air leakage continued, and pleurodesis was performed. Although she had no skin eruptions or renal tumors, Birt-Hogg-Dube (BHD) syndrome was suggested by radiographic findings. BHD gene analysis was performed, which revealed the BHD gene mutation. Reevaluation of pathological findings showed elastic fibers in the alveolar walls with fine granular changes and accumulation of macrophages. BHD syndrome should be considered in patients presenting with multiple pulmonary cysts with or without skin eruption, or kidney tumor.

This study assessed the utility of machine learning for isolating noise and artifacts in breast ultrasound images. Such corrupt image regions (ROIs) can be automatically excluded when registering images acquired from different angles. Artifacts included posterior acoustic shadowing and enhancement arising from cancers and cysts respectively. Images were obtained on a breast-mimicking phantom containing multiple cysts and lesions with variable speed of sound and attenuation properties. In vivo breast images of cysts and cancers were also available. Results show that the classifiers were able to identify the regions of corrupt data accurately.

Benign cystic mesothelioma is a very rare tumor characterized by its benign clinical behavior, although local recurrence seems to occur frequently after the intervention. This neoplasm is composed of multiple small fluid-filled cysts. A 36-year-old woman, gravida 2, para 2 (2 cesarean sections), with dysmenorrhea, who underwent bilateral paratubal cyst excision 13 years before, presented to our department. Preoperative ultrasonography showed multiple cysts in the pouch of Douglas containing a dense fluid (Fig. 1). Tumor markers were within normal limits. Subsequent laparoscopy revealed a conglomerate of cystic structures (7 ! 9 cm) attached to the postero-fundic wall of the uterus, that spread to the pouch of Douglas (Fig. 2).

Hydatid disease is endemic and represents a major health problem in Yemen. The aim of this study is to determine the magnitude of the problem of hydatidosis in patients attending Public and Private Hospitals at Sana'a city, Yemen.66 patients with hydatid disease were identified during the period from August 2006 to February 2007. Complete medical history for all CE patients were collected and analyzed.Among the 66 CE patients, 67% were females and 33% males. Liver was the most common involved organ. Single cyst was more frequently detected than multiple cysts and approximately 94% of the cysts were ≥5 cm. Moreover, Public hospitals were the main source of patients with CE disease.Hydatidosis is still an endemic disease and an important health problem in Yemen which needs to be studied further. Therefore, accurate information on the distribution of the disease is the first step for the control and prevention of the disease. Moreover, it is crucial to investigate the role of different intermediate hosts and genotypes of E. granulosus in humans and animals.

Polycystic kidney disease (PKD) is a disease characterized by development of multiple cysts within the kidneys in bilateral fashion. A cyst is defined as a fluid-filled sac lined with a single layer of tubular epithelium. A cystic kidney is defined as a kidney that contains three or more cysts.

Magnetic resonance images of 47 patients with postoperative maxillary cyst were analyzed for size, location, and signal intensity. The smallest cyst was confirmed at surgery to be 1cm×1cm×1cm and the largest 5cm×5cm×5cm.The cysts were usually found in the superomedial and inferomedial parts of the maxillary sinus (44%). Many patients (60%) had multiple cysts or bilateral cysts (30%).In most the signal intensiy was low in the T1-weighted SE (500/40) images and high in the T2-weighted SE (2000/80) images.Cysts with a hemorrhagic component, though rare, showed high signal intensity in both T1-and T2-weighted images.

Microcystic lymphangioma is difficult to treat with sclerotherapy or surgical resection alone. It is impossible to inject sclerosing agents into multiple cysts and surgical resection may sacrifice neighboring organs. We report a case of clinically regressed microcystic lymphangioma by sclerotherapy with OK-432 after intralesional excision. This is an alternative effective method in the treatment of microcystic lymphangioma. However, because histological examination revealed remaining lymphangioma, the possibility of recurrence remains.

The principal features of computed tomography in hydatid disease of the lungs were reviewed in ten patients with surgically verified hydatid disease of the lungs. On the basis of localization and multiplicity, hydatid cysts of the lungs can be classified in three distinct categories: single unilateral unilocular cysts with or without daughter cysts, unilateral multiple cysts with or without daughter cysts, and bilateral multiple cysts. Cystobronchial communication may lead to cavitary lesions, while infection of the cyst may alter the attenuation values and produce a solid appearance. On the basis of density and clinical symptoms, hydatid cysts of the lungs can be classified as simple cysts, complicated cysts, and ruptured cysts, including cystobronchial communication.

We report the long-term outcome of surgery for cerebral hydatid cyst in 12 children. In only one child, who had been operated on for cardiac hydatidosis a year earlier, was the brain cyst known to be secondary. Of the 12 children. 10 had a single cyst and 2 had multiple cysts. Five single cysts were removed intact by “hydatid birth,” two cysts—one single and one multiple—were removed after puncture and aspiration of the cyst fluid, and the other five—four single and one multiple—were accidentally ruptured in the course of the operation. One patient died of infection of the residual space. 2 died of intracranial recurrence of the parasite (7 and 22 months later, respectively), and one. the child with secondary cerebral echinococcosis, died 6 years later of systemic echinococcosis. Eight patients who had a mean follow-up of 28 years are still living and enjoy very good health, both general and neurological. This long-term follow-up with such good results confirms the usually primary character of cerebral hydatid disease, at least in children. The combination of patent ductus arteriosus and ingestion of unboiled animals' milk might well explain how primarv cerebral hvdatid disease develops in children.

Meckel憩室にみられる悪性腫瘍, 特に癌腫はまれであり, 欧米23例, 本邦5例が報告されているに過ぎない.Meckel憩室から発生した胎児遺残組織由来と思われる癌腫の症例を報告する.症例は43歳, 男性で, 下腹部不快感, 下腹部腫瘤を訴え入院した.人院時, 左下腹部に手掌大で弾性硬の腫瘤を触知した.検査成績では, carcinoembryoni cantigen 4.3ng/ml, α-fetoprotein36ng/mlと高値を呈した.以上の所見と画像診断より腹部悪性腫瘍の診断で手術を施行した.開腹すると回盲部より約130cmの部位にMeckel憩室があり.その先端に手掌大の腫瘍を認め, 腫瘍は結腸間膜を押し分けるように後方に発育していた.手術は腫瘍を含めてMeckel憩室を切除し, 結腸の一部を合併切除した.組織では, 腫瘍はMeckel憩室の筋層と連続した多嚢胞形成性のadenosquamous carcinomaでhuman vitelline structureを模倣する構造も認め, Meckel憩室から発生した胎児遺残組織由来の癌腫と考えられた.術後7か月の現在, 経過は良好である.

A case of breast carcinoma forming multiple cysts is presented. The patient was a 67-year-old female with multiple tumors in the right breast. Mammography showed dense tumor shadows with microcalcification. Echography revealed multiple cysts with intracystic protrusion. Furthermore, the tumors were displayed as hot region by thermography. A radical mastectomy was performed after excision of the tumors. The cut surface of the tumors showed multiple cysts with a protrusion. Light microscopically, several cysts showing proliferation of intracystic papillo-tubular carcinoma were observed. From these findings, we considered that the cystic tumors in this case might be a special type of intracystic carcinoma of the breast. Generally, intracystic carcinoma of the breast is considered to arise from malignant transformations of an intraductal papilloma or a benign cyst wall. However, we speculated that the tumors of the present case were formed of the obstruction of ducts by an intraductal carcinoma.

A uterine adenomyoma of endocervical type was presented histopathologically in a 44-year-old woman. She had a mural tumor of the uterine endocervix, which showed a well-circumscribed margin and multiple cysts filled with mucin. Histologically, the tumor was composed of a proliferation of endocervical glands and smooth muscle. The glandular epithelial components were cystic and occasionally papillary, but neither component showed cytological atypia. A differential diagnosis of the uterine endocervical tumor should include adenomyoma of endocervical type.

Purpose: To investigate the relationship between filtering bleb function and Stratus optical coherence tomography (OCT) images. Methods: We studied 72 eyes of 65 consecutive patients who had a fornix-based conjunctival flap in primary trabeculectomy with mitomycin C (MMC). Filtering blebs with various types of glaucoma were examined using Stratus OCT. Success rates were defined as intraocular pressure (IOP) ≤ 15 mmHg and IOP reduction ≥ 25% without medication or additional surgery. Success rates among classified groups were compared using Kaplan–Meier survival curves and the log-rank test. Results: Blebs were classified into three different categories on the basis of the following Stratus OCT patterns: cystoid type (multiple cysts inside the bleb; 17 eyes), diffuse type (low to high reflective areas that were mixed inside the bleb; 31 eyes) and layer type (medium to high reflective layer inside the bleb; 24 eyes). Success rates in the cystoid-, diffuse- and layer-type blebs were 94%, 97% and 75% (P = 0.02), respectively. Conclusion: In trabeculectomy with MMC and a fornix-based conjunctival flap, there is a significant association between the success rates and the postoperative Stratus OCT findings of filtering blebs.

Pulmonary Langerhans cell histiocytosis is a rare pulmonary disease that typically affects cigarette smokers from 30–40 years of age onwards. It is very rare in children, especially for those under 15 years of age. We report an atypical radiological manifestation of isolated pulmonary Langerhans cell histiocytosis in a 12-year-old girl that showed multifocal consolidation and multiple small nodules on an initial chest radiograph, and gradual fibrotic change with multiple cysts on follow-up chest radiographs and CT scans.

We encountered a case of Basal cell nevus syndrome in which multiple cysts occurred during long-term follow-up.The patient was a 8-year-old boy. Frontal and temporal bossing, ocular hyperterolism, mandibular prognathism, multiple jaw cysts, pit, calcification of the flax cercbri and bifid-rib were observed.Primordial cyst in tire kit maxilla and follicular cysts in the bilateral mandible were confi rmed 4 years after the operation for the left mandibular cyst. From the histopthological investigation, the process of cyst formations in this ease seemed to be identical with Broca's theory. The growth of the cysts was rapid in a short period of 1-2 years.We performed an enucleation with closure for the c ysts in the maxilla and enucleation with packing open for those in the mandible. No recurrence has occurred up to now, but a long-term follow-up is required in consideration of occurrence and recurrence of the cyst.

Ependymoma is a slowly growing tumor appearing mostly in children and young adults. Several histological patterns are described. We report a case with unusual microscopic features, composed mostly of multiple cysts. Ultrastructural and immunohistochemical examination confirmed the diagnosis. Neuropathologists should be aware of this particular change which can generate some diagnostic difficulties.

Intracranial capillary hemangiomas are very rare, though several spinal capillary hemangiomas have recently been reported. We report here a case of intracranial capillary hemangioma with multiple cysts and review the current literature of similar cases. A 4-month-old girl was referred to our hospital for treatment of hydrocephalus and a cerebellar mass lesion. She presented with hemangiomas distributed widely over the body, as well as disseminated hemangiomas in the pleura, liver, spleen, pancreas, kidneys and vagina. Pathological examination of the specimen from the vagina confirmed the diagnosis of a capillary hemangioma made at another hospital. Radiological examination of the brain revealed a cystic mass lesion in the left cerebellar hemisphere with subsequent obstructive hydrocephalus. The cysts extended upward into the bilateral ventricle. Following neuroendoscopic fenestration of the cysts, resection of the left cerebellar mass was performed. Histological examination of the lesion demonstrated similarly sized capillaries, and the pathological diagnosis was confirmed as capillary hemangioma. There was no recurrence postoperatively. Our patient was treated successfully by surgical resection and neuroendoscopic procedures. Surgical intervention may therefore be indicated in intracranial capillary hemangiomas.

We present a case of a patient with multiple cerebral hydatidosis. We could not find any other origin of hydatidosis. In the light of the radiodiagnostic and biochemical findings, we assessed this case as a primary cerebral hydatidosis. The cysts were delivered completely. Two months after operation, the patient's neurological examination and control MRI were normal.

We report the sonographic features of an intracystic papillary carcinoma of the breast presenting as recurrent hemorrhagic cysts following trauma. A 56-year-old woman presented with palpable breast masses after a traumatic event; sonography showed multiple, well-defined, hemorrhagic cysts. Hemorrhagic fluid was evacuated by fine needle aspiration with no residual lesions. Cytology was negative for malignancy. Five months later, the mass reappeared; sonography demonstrated multiple cysts with solid nodules. US-guided core biopsy and surgery revealed invasive papillary carcinoma. We suggest close follow-up of cystic masses, even with negative cytology, and performance of surgical excisional biopsy in cases of rapid refilling after aspiration.

Microcystic adenoma or serous cystadenoma is an uncommon tumor and accounts for 1-2% of the exocrine neoplasms of the pancreas. Usually unifocal, they present as single, large, well-demarcated multiloculated cystic tumors, ranging in size from 1 to 25 cm. Multifocal variants or diffuse serous cystadenomas are extremely rare. We present 2 cases of which 1 is a diffuse variant affecting the body, tail and part of the neck of the pancreas. In both the patients the tumors were detected incidentally. We highlight on the diffuse variant in view of its rarity and present a review of literature. In this case the entire body and tail of the pancreas was spongy replaced by multicystic lobules and hyalinized fibrocollagenous stroma. The cysts were lined by low cuboidal glycogen containing bland cells. Such a unique presentation wherein the entire body and tail of the pancreas is replaced with multiple cysts is a diffuse presentation of microcystic adenoma and a search through literature revealed only 7 such cases among the 15 cases with multifocal presentation reported.

Purpose The purpose of this study was to determine the MR appearance of struma ovarii correlating with the pathological features. Method MR findings of two patients with struma ovarii were retrospectively reviewed and compared with the pathological findings. Results Both tumors were complex masses composed of multiple cysts and solid components. The size and signal intensity of multiple cysts varied within the tumor. Hyperintense cystic areas on T1-weighted images were thought to correspond pathologically to hemorrhagic cysts and follicles containing viscous proteinaceous colloid. Solid components had as high a signal intensity as did uterine endometrium on T2-weighted images and as intermediate a signal intensity as did uterine muscle layer on T1-weighted images. After intravenous administration of gadolinium-DTPA, the solid components showed marked contrast enhancement. There was also ascitic fluid associated with adhesion and peritoneal thickening. Conclusion The characteristic MR appearance of struma ovarii is thought to be a mixed mass composed of T2-hyperintense solid components with intense contrast enhancement and multiple T1-hyperintense cystic areas suggestive of hemorrhagic degeneration and viscous proteinaceous colloid.

The purpose of this clinical study was to evaluate the usefulness of laparoscopic fenestration of symptomatic liver cysts. Between September 1996 and September 2001, 6 patients underwent laparoscopic fenestration for symptomatic hepatic cysts. All 6 patients were women. The mean age was 59.5 (range 40-74). Two patients had single and 4 had multiple cysts. The mean diameter of the lesions, measured by preoperative computed tomography (CT), was 16.8 cm (range 10-20). The indications for surgical treatment included abdominal fullness associated with pain or dyspepsia. The surgical procedure involved puncture and aspiration of the cyst and subsequent circular electroresection of the cystic wall. Laparoscopic fenestration was successfully done in all 6 patients. The operating time was 148 minutes (range 110-215). Mean blood loss was 93 mL (range 5-300). Histologic examination of the cyst wall showed 5 simple cysts and 1 papillary serous cystadenoma. There were no intraoperative or postoperative complications. The mean hospital stay after surgery was 4.3 days (range 3-5). Complete relief of symptoms was achieved in 5 patients during the postoperative follow-up (range 2-6 years, mean 4). Follow-up CT (1 month to 4 years) has shown regression of the cysts in all patients (mean 3.8 cm, range 2-8). Laparoscopic fenestration of symptomatic liver cysts is a simple and effective method to relieve symptoms with minimal surgical trauma.

We report an extremely rare case of primary diffuse alveolar septal amyloidosis associated with multiple cysts and calcification. Development of multiple cysts may have resulted from fragile alveolar walls, as a consequence of amyloid deposition both on alveolar walls and around capillaries.

Lymphangiomas are fairly well-circumscribed benign masses of lymphatic vessels or channels that vary in size, are usually greatly dilated, and are lined with normal endothelial cells. They may be classified into 3 groups: lymphangioma simplex, consisting of capillary-sized channels; cavernous lymphangiomas, consisting of dilated channels with a fibrous adventitial covering; and cystic lymphangiomas, or hygromas, composed of multiple cysts of varying sizes that are lined with endothelial cells. Mixed types may coexist within a given lesion. Although lymphangiomas can occur in any part of the body where lymphatic ducts are located, 95% of them are found in the neck, the head, or the axilla. 1 When they occur in the lateral and posterior neck region, they are frequently associated with chromosomal abnormalities and with hydrops. Isolated lymphangiomas in other parts of the body are not associated with other malformations or with chromosomal syndromes. When neck lymphangiomas are detected, a karyotype should be obtained, and a search for evidence of hydrops should be done because some of these fetuses are likely to have chromosomal anomalies, and when associated with hydrops, survival is unlikely.

1. Repaired facial nerve recovery grading system a. Recognize it is difficult to use the House-Brackmann classification to report functional results when a facial nerve has undergone repair b. Iowa Repaired Facial Nerve Recovery Scale [1] 2. Objective facial nerve grading systems a. Promising for the future b. Continue to study 3. Cystic nature of tumors a. Identify as separate group b. Consider cystic if there are cysts or multiple cysts on the surface of the tumor 4. Adhesion of tumor a. Unable to measure; highly subjective 5. Vascularity of tumor a. Unable to measure; highly subjective

A middle-aged female presented with a 7-month history of a non-tender mobile lump in the right axilla. Ultrasonography demonstrated a 40×38 mm lymph node with no hilum. A smaller (28×25 mm) mammographically detected axillary lymph node had been resected from the patient's right axilla 3 years earlier, at which time histology reported a benign squamous epithelial cyst inclusion. The clinical and radiological breast examination was normal on both occasions. Following a non-malignant, yet inconclusive, ultrasound-guided needle core biopsy result, the lymph node was surgically excised from the lower axilla (level 1) where it was attached on the serratus anterior muscle. Complete histological examination reported reactive changes and multiple cysts lined by keratinising squamous epithelium (figure 1), with no evidence of cellular atypia or …

Cysticercosis is a parasitic infection with CNS involvement in 60-90% of infested patients. The larval form of pork intestinal tapeworm (Taenia solium) is responsible for cysticercosis. Humans are the definitive hosts and usually harbor the adult tapeworm in small intestine as an asymptomatic infestation. Neurocysticercosis most commonly affects the brain parenchyma. Solitary and multiple cysts in brain parencyma is common but we came across a 24 year old lady patient with huge number of cysts which is relatively rare. The aim of this article is to report the rare case. DOI: http://dx.doi.org/10.3126/mjsbh.v10i1.6450 Medical Journal of Shree Birendra Hospital Jan-June 2011 10(1) 44-45

A report of two unusual and remarkably similar cases of multicystic acoustic neurinoma in 46 and 60 year old patients is presented. The clinical presentation mimicked a regular acoustic neurinoma. The tumours in each case were similar in their radiological appearance. The entire tumour had a honeycomb appearance with well defined and multiple cysts. Each cyst contained xanthochromic fluid. Like in any other cystic acoustic neurinoma, the presence of multiple cysts made internal decompression of the tumour relatively easy but the dissection of the tumour from the adjoining cranial nerves was difficult. The pathogenesis of multiple cysts is analyzed and the literature on this subject is briefly reviewed.

Mucocele-like lesions of the breast were first described in the pathology literature in 1986. No series of the mammographic appearances of these lesions has been described. These benign breast lesions are composed of minute multiple cysts lined by uniform flat or cuboidal to columnar epithelium. Microscopically, microcalcifications are frequently present within the cysts and extravasated mucus. These lesions may mimic the microcalcifications of ductal carcinoma in situ at screening mammography.

Oncocytic cystadenoma is a benign tumor of salivary glands, histologically characterized by multicystic growth of the oncocytic epithelial lining. Crystals in different shapes and nature associate oncocytic type of salivary gland neoplasms. An 82 year-old woman with right parotideal mass had an operation of superficial parotidectomy. Histological examination revealed multiple unilocular or multilocular cystic lesions with incomplete fibrous capsule, papillary foldings, and 1 or 2 layers of oncocytic epithelium lines. The epithelium lining the cysts were positive for CK8, CK14, CK18, CK19, and negative for SMA, S-100, and p63 immunohistochemically. Cystadenomas were described as mostly multilocular and we presented a multifocal cystic neoplastic lesion lined by oncocytic type epithelial cells with intraluminal crystalloids. Multiple cysts forming morphology, incomplete fibrous capsule of most cysts and immunohistocemical findings were considered as multiple oncocytic cystadenoma with intraluminal crystalloids in the parotid gland.

Intralingual cysts lined by epithelium of foregut origin are rarely reported. We present 16 patients seen over an 8-year period (1983 to 1990) with such lesions. Respiratory and squamous epithelium were the most commonly encountered. These unusual cysts generally presented in the neonatal period with feeding difficulty. Two children had multiple cysts. Histological varieties of epithelia are described and the clinical features are discussed. From our experience we conclude that these cysts are adequately treated by complete surgical excision through a sagittal glossal split. This can be safely done electively in the neonatal period. Cyst aspiration was found to be inadequate definitive treatment.

We describe a case of placental surface cyst. Intrauterine growth restriction or maternal floor infarction occurs in about 10% of cases [Brown DL, DiSalvo DN, Frates MC, et al. Placental surface cysts detected on sonography: histologic and clinical correlation. J Ultrasound Med. 2002;21(6):641–8]. Large or multiple cysts seem to have a higher frequency of these complications. To the best of our knowledge, there are a few reports about MR imaging of placental surface cysts.

We have analyzed matched serum and breast cyst fluid samples for total PSA from 148 patients with fibrocystic breast disease. We have also determined the molecular forms of PSA (free PSA and PSA bound to α(1)‐antichymotrypsin) in 78 breast cyst fluid samples. We found that total PSA can be detected in all cyst fluids and in about 75% of female sera. The median total PSA concentration in breast cyst fluid (bcf) is about 30 times higher than the median in the corresponding sera. Breast cyst fluid and serum PSA are not correlated with each other. Total serum PSA is inversely associated with patient age but the inverse association between bcf PSA and age is weak. Lower total PSA in bcf was seen in women who breast feed, and higher bcf PSA is associated with multiple cysts. Type I cysts (with a high K(+)/Na(+) ratio) tend to have higher total PSA than Type II cysts. All but three of the fractionated cyst fluids (75/78; 96%) had free PSA as the predominant molecular form. The most consistent finding of our study was the positive association between the cyst fluid K(+)/Na(+) ratio and the free to bound PSA ratio. This association was confirmed by Spearman correlation as well as by Wilcoxon and chi‐square analysis. Secretory/apocrine cysts (Type I) tend to have more total PSA and proportionally more free PSA than transudative/flattened cysts (Type II). J. Clin. Lab. Anal. 13:75–81, 1999. © 1999 Wiley‐Liss, Inc.

A case of pure struma ovarii is reported with its CT, magnetic resonance (MR), and pathologic findings. Both MR and CT revealed a complex mass composed of solid elements and multiple cysts; CT revealed calcifications not apparent on MR.

A case of multiple oncocytic cysts with intraluminal tyrosine-rich crystalloids involving the parotid gland is described. The microscopic and ultrastructural findings are presented.

A 62-year-old man was evaluated for lower urinary tract symptoms. Imaging studies showed a normal prostate and multiple cysts between the rectum and bladder with no evident communication to the prostate. On pathology, papillary cystadenocarcinoma with positive immunohistochemical staining for PSA was confirmed.

Hydatid disease is relatively frequent in our country. Asymptomatic hydatid disease may present with complications, but unusual locations as well as multiple primary or secondary hydatid disease pose special diagnostic and therapeutic challenges. In humans, hydatid disease commonly involves the liver (75%) and the lungs (15%). The remaining (10-15%) of the cases involve other regions of the body. Synchronous multiple cysts represent less than 2% of all cases. The disseminated intra-peritoneal hydatid disease is a very rare finding. We report such a presentation wherein the abdominal cavity, retro peritoneum and pelvis contain multiple hydatid cysts. The challenges encountered in the diagnosis and treatment of this patient are highlighted.

We are here with presenting four cases of intracranial hydatid cysts that are managed at Department of Neurosurgery, Government General Hospital Kurnool between 2010 and 2013. The mean age of presentation is 25 years. One patient had primary solitary cyst, second patient had primary unilateral multiple cysts, third patient had secondary (metastatic) bilateral multiple cysts and fourth had secondary multiple cysts presenting with unilateral proptosis. All patients were presented with signs of raised intracranial pressure. Radiological investigations included computed tomography and magnetic resonance imaging.

Magnetic resonance imaging (MRI) is superior to conventional X-ray tomography and CT scanning in detecting postoperative maxillary cysts (POMCs). We analyzed the MRI features of 51 cases (72 sides) and compared them with the operative findings of 42 cases (52 sides) of POMC. The total number of cysts diagnosed was 121. Multiple cysts were found in 37 sides (51%) and bilateral cysts were found in 21 cases (45%). According to classification of POMC based on location in the maxilla the central cysts were found in only 38% of all cysts (peripheral ones in 62%). In the 42 patients operated on, 69 of 83 cysts which had been detected by MRI were confirmed, whereas there were two additional cysts which could not be diagnosed preoperatively. Sixty four of 71 cysts were opened to the nasal cavity under endonasal endoscopic control. The other seven cysts (five sides) were operated on via a buccogingival incision. Detailed and accurate diagnosis by MRI and development of endoscopic instruments enabled endonasal surgery in most (91%) sides of the POMC. In five cysts of the superior type which are small isolated and distant from the lateral wall of the nasal cavity, endoscopic endonasal surgery was not indicated. In conclusion, MRI for POMC was extremely helpful in selecting a surgical approach.

Oncocytic papillary cystadenoma (OPC) is a rare, benign lesion of the larynx thought to arise from minor seromucinous glands in the area. These lesions tend to occur in the seventh and eighth decades of life and are known to be associated with smoking. OPC occur more frequently as single cysts and rarely in a more diffuse pattern as multiple cysts. Previously, these were considered true neoplasms, however more recent literature suggests that this is a metaplastic process. We present a case occurring in a 53-year-old man who on endo-scopic examination was thought to have multiple squamous cell carcinomas. We received three specimens. The first specimen was a supraglottic OPC showing papillary projections lined by columnar oncocytic cells with typical abundant eosinophillic granular cytoplasm. The further two specimens confirmed the presence of squamous cell carcinoma. Both lesions appear unrelated. While regarded as benign, it has been suggested that these lesions can rarely recur and follow-up is recommended. We discuss the histo-morphological features of this rare entity with the aim to increase awareness.

Intratesticular cysts, once thought to be a rarity, are now being reported with an increasing prevalence as a result of the wider use of scrotal ultrasound scanning. Despite greater understanding of intratesticular cysts, their management remains unclear. Treatment has included enucleation and even radical orchiectomy over fear of the possibility of an associated malignancy. A more conservative approach with serial ultrasound scanning has been advocated if a clear distinction can be made between neoplastic and non-neoplastic testicular cysts. However, in view of the benign nature of such cysts, even repeated ultrasound scanning may not be necessary and may be considered over-treatment. In this study we present clinical and morphological characteristics of multiple cysts in the right testicle in a 62-year-old patient, where a slightly nodular lesion in the right testicle was detected.

The occurrence of intracystic hemorrhage in benign liver cysts is usually seen in huge solitary cysts in older individuals. Hemorrhage complicating one of the multiple cysts has rarely been reported. We report a case of multiple simple hepatic cysts with intracystic hemorrhage complicating one of the cysts. A 60-year-old woman was admitted with complaints of abdominal discomfort of 6 months duration and abdominal pain with increasing intensity of 2 months duration, not responding to analgesics and was anicteric. On thorough evaluation, a diagnosis of complicated liver cyst was made and her severe symptoms necessitated intervention. Per-operatively, multiple thick walled huge cysts were seen on the surface of the liver. The largest one in the right lobe was complicated by hemorrhage. The cysts were aspirated and deroofed. There were no solid components or biliary communications in the cysts.

The authors report four patients with intracranial hydatic cysts. One patient had a pontine lesion which was punctured and aspirated and the cyst wall removed with a satisfactory outcome. The second patient had multiple cysts which was comparable to meningeomatosis. She had a rapidly deteriorating neurologic condition which proved to be fatal in spite of two consecutive surgical interventions. The third patient had nine lesions although only six were evident on the MRI. All of the cysts were removed, while two cysts ruptured. Multiple paracardial cysts of this patient were surgically removed shortly after the craniotomy. The last patient, again with multiple intracranial hydatid cysts had safe, total removal of all cysts. The first postoperative control CT raised the possibility of recurrence since the CT was highly suggestive of a hydatid cyst. However, this was not confirmed in the follow-up CT examination. Problems and the solutions of management are discussed.

The case described is a 35-year-old male with multiple cysts on the upper half of his body. This patient was diagnosed as having steatocystoma multiplex, based on clinical and histological findings. The lesions consisted of widespread and unusually prominent cysts, which were removed by a simple surgical technique using a dermatological trepan and artery forceps. We provide here a detailed description of the surgical procedures employed.