Difference between revisions of "Ganglion cyst"

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{{ Infobox diagnosis
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Name      = {{PAGENAME}}
| Image      = Ganglion_Cyst,_Hand.jpg  
| Image      = Ganglion cyst -- low mag.jpg
| Width      =
| Width      =
| Caption    = Ganglion cyst of the hand. [[H&E stain]].   
| 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        =
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| 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  =
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| 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/1253223-overview http://emedicine.medscape.com/article/1253223-overview]]. Accessed on: 8 February 2012.</ref>
**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==
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*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.


<br>
Note:
† The entity is really a pseudocyst.<ref name=emed_gc/>
*† The entity is really a pseudocyst.<ref name=emed_gc/>


DDx:
DDx:
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*[[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:
48,851

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