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Difference between revisions of "Ganglion cyst"
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{{ Infobox diagnosis | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | | Name = {{PAGENAME}} | ||
| Image = | | Image = Ganglion cyst -- low mag.jpg | ||
| Width = | | Width = | ||
| Caption = Ganglion cyst | | Caption = Ganglion cyst. [[H&E stain]]. | ||
| Synonyms = | | Synonyms = | ||
| Micro = empty space(s) - usually multiple; fibrotic wall without an epithelial lining +/- myxoid change +/- spindled fibroblasts | | Micro = empty space(s) - usually multiple; fibrotic wall without an epithelial lining +/- myxoid change +/- spindled fibroblasts | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = [[synovial cyst]], [[juxta-articular myxoma]], (other) myxomas, [[digital mucous cyst]] | | LMDDx = [[synovial cyst]], [[juxta-articular myxoma]], (other) myxomas, [[digital mucous cyst]], [[myxoid lesions]] | ||
| Stains = | | Stains = | ||
| IHC = | | IHC = | ||
| Line 15: | Line 15: | ||
| Gross = | | Gross = | ||
| Grossing = | | Grossing = | ||
| Site = [[soft tissue lesions|soft tissue]] - esp. hand | | Site = [[soft tissue lesions|soft tissue]] close to [[joints]] - esp. in hand | ||
| Assdx = | | Assdx = | ||
| Syndromes = | | Syndromes = | ||
| Line 28: | Line 28: | ||
| Other = | | Other = | ||
| ClinDDx = | | ClinDDx = | ||
| Tx = | | Tx = surgical excision or conservative management | ||
}} | }} | ||
'''Ganglion cyst''' is a small benign [[ditzel]] classically found on the wrist. | '''Ganglion cyst''' is a small benign [[ditzel]] classically found on the wrist. | ||
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==General== | ==General== | ||
*Very common. | *Very common. | ||
**Most common tumour of the hand.<ref name=emed_gc>URL: [http://emedicine.medscape.com/article/ | **Most common tumour of the hand.<ref name=emed_gc>URL: [http://emedicine.medscape.com/article/1243454-overview http://emedicine.medscape.com/article/1243454-overview]. Accessed on: 8 February 2012.</ref> | ||
*Classically on the wrist.<ref name=pmid17488856>{{Cite journal | last1 = Hasham | first1 = S. | last2 = Burke | first2 = FD. | title = Diagnosis and treatment of swellings in the hand. | journal = Postgrad Med J | volume = 83 | issue = 979 | pages = 296-300 | month = May | year = 2007 | doi = 10.1136/pgmj.2005.043992 | PMID = 17488856 }}</ref> | *Classically on the wrist.<ref name=pmid17488856>{{Cite journal | last1 = Hasham | first1 = S. | last2 = Burke | first2 = FD. | title = Diagnosis and treatment of swellings in the hand. | journal = Postgrad Med J | volume = 83 | issue = 979 | pages = 296-300 | month = May | year = 2007 | doi = 10.1136/pgmj.2005.043992 | PMID = 17488856 }}</ref> | ||
*May be painful.<ref name=Ref_Derm322>{{Ref Derm|322}}</ref> | *May be painful.<ref name=Ref_Derm322>{{Ref Derm|322}}</ref> | ||
*Many (~60%) regress if left alone.<ref name=pmid24967120>{{Cite journal | last1 = Suen | first1 = M. | last2 = Fung | first2 = B. | last3 = Lung | first3 = CP. | title = Treatment of ganglion cysts. | journal = ISRN Orthop | volume = 2013 | issue = | pages = 940615 | month = | year = 2013 | doi = 10.1155/2013/940615 | PMID = 24967120 }}</ref> | |||
==Gross== | ==Gross== | ||
| Line 44: | Line 45: | ||
*Metacarpal boss - degenerative [[arthritis]].<ref name=pmid432327>{{Cite journal | last1 = Cuono | first1 = CB. | last2 = Watson | first2 = HK. | title = The carpal boss: surgical treatment and etiological considerations. | journal = Plast Reconstr Surg | volume = 63 | issue = 1 | pages = 88-93 | month = Jan | year = 1979 | doi = | PMID = 432327 }}</ref> | *Metacarpal boss - degenerative [[arthritis]].<ref name=pmid432327>{{Cite journal | last1 = Cuono | first1 = CB. | last2 = Watson | first2 = HK. | title = The carpal boss: surgical treatment and etiological considerations. | journal = Plast Reconstr Surg | volume = 63 | issue = 1 | pages = 88-93 | month = Jan | year = 1979 | doi = | PMID = 432327 }}</ref> | ||
*[[Giant cell tumour of tendon sheath]]. | *[[Giant cell tumour of tendon sheath]]. | ||
===Image=== | |||
<gallery> | |||
Image: Ganglion-cyst.jpg | Ganglion cyst of the hand. (WC) | |||
</gallery> | |||
==Microscopic== | ==Microscopic== | ||
Features:<ref name=emed_gc>URL: [http://emedicine.medscape.com/article/1243454-overview http://emedicine.medscape.com/article/1243454-overview]. Accessed on: 8 February 2012.</ref><ref name=Ref_Derm322>{{Ref Derm|322}}</ref> | Features:<ref name=emed_gc>URL: [http://emedicine.medscape.com/article/1243454-overview http://emedicine.medscape.com/article/1243454-overview]. Accessed on: 8 February 2012.</ref><ref name=Ref_Derm322>{{Ref Derm|322}}</ref> | ||
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**May have some spindled fibroblasts. | **May have some spindled fibroblasts. | ||
Note: | |||
† The entity is really a pseudocyst.<ref name=emed_gc/> | *† The entity is really a pseudocyst.<ref name=emed_gc/> | ||
DDx: | DDx: | ||
| Line 59: | Line 66: | ||
*[[Juxta-articular myxoma]]. | *[[Juxta-articular myxoma]]. | ||
*Myxoma. | *Myxoma. | ||
*Other [[myxoid lesions]]. | |||
*[[Digital mucous cyst]] - has many spindled fibroblasts, usu. superficial.<ref name=Ref_Derm322>{{Ref Derm|322}}</ref> | *[[Digital mucous cyst]] - has many spindled fibroblasts, usu. superficial.<ref name=Ref_Derm322>{{Ref Derm|322}}</ref> | ||
*[[Nodular hidradenoma]]. | |||
===Images=== | ===Images=== | ||
<gallery> | <gallery> | ||
Image: Ganglion cyst -- very low mag.jpg | GC - very low mag. (WC) | |||
Image: Ganglion cyst -- low mag.jpg | GC - low mag. (WC) | |||
Image: Ganglion cyst -- intermed mag.jpg | GC - intermed. mag. (WC) | |||
Image: Ganglion cyst - alt -- intermed mag.jpg | GC - intermed. mag. (WC) | |||
Image:Ganglion_Cyst,_Hand.jpg | Ganglion cyst of the hand. (WC/Uthman) | Image:Ganglion_Cyst,_Hand.jpg | Ganglion cyst of the hand. (WC/Uthman) | ||
</gallery> | </gallery> | ||
www: | www: | ||
*[http://www.surgicalpathologyatlas.com/glfusion/mediagallery/media.php?f=0&sort=0&s=2008080217190580 Ganglion cyst (surgicalpathologyatlas.com)]. | *[http://www.surgicalpathologyatlas.com/glfusion/mediagallery/media.php?f=0&sort=0&s=2008080217190580 Ganglion cyst (surgicalpathologyatlas.com)]. | ||
==Stains== | |||
*Alcian blue +ve (mucin).<ref name=pmid24891856 >{{Cite journal | last1 = Park | first1 = JH. | last2 = Im | first2 = SB. | last3 = Kim | first3 = HK. | last4 = Hwang | first4 = SC. | last5 = Shin | first5 = DS. | last6 = Shin | first6 = WH. | last7 = Kim | first7 = BT. | title = Histopathological findings of hemorrhagic ganglion cyst causing acute radicular pain: a case report. | journal = Korean J Spine | volume = 10 | issue = 4 | pages = 242-5 | month = Dec | year = 2013 | doi = 10.14245/kjs.2013.10.4.242 | PMID = 24891856 | PMC = 4040643}}</ref> | |||
===Images=== | |||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4040643/figure/F4/ Ganglion cyst - Alican blue staining (nih.gov)].<ref name=pmid24891856/> | |||
==Sign out== | ==Sign out== | ||
<pre> | |||
Soft Tissue (Submitted as "Ganglion from Left Wrist"), Excision: | |||
- Ganglion cyst. | |||
</pre> | |||
===Block letters=== | |||
<pre> | <pre> | ||
SOFT TISSUE ("GANGLION CYST"), LEFT WRIST, EXCISION: | SOFT TISSUE ("GANGLION CYST"), LEFT WRIST, EXCISION: | ||