|Diagnosis in short|
Ganglion cyst. H&E stain.
|LM||empty space(s) - usually multiple; fibrotic wall without an epithelial lining +/- myxoid change +/- spindled fibroblasts|
|LM DDx||synovial cyst, juxta-articular myxoma, (other) myxomas, digital mucous cyst, myxoid lesions|
|Site||soft tissue close to joints - esp. in hand|
|Treatment||surgical excision or conservative management|
Ganglion cyst is a small benign ditzel classically found on the wrist.
- Very common.
- Most common tumour of the hand.
- Classically on the wrist.
- May be painful.
- Many (~60%) regress if left alone.
- Mass at a joint - classically in the hand.
DDx - clinical:
- Empty space(s); usually multiple.
- Fibrotic wall.
- No epithelial lining.†
- +/-Myxoid change - very common.
- May have some spindled fibroblasts.
- † The entity is really a pseudocyst.
- Synovial cyst - true cyst (has an epithelial lining), villous projections into the cystic space.
- Juxta-articular myxoma.
- Other myxoid lesions.
- Digital mucous cyst - has many spindled fibroblasts, usu. superficial.
- Alcian blue +ve (mucin).
Soft Tissue (Submitted as "Ganglion from Left Wrist"), Excision: - Ganglion cyst.
SOFT TISSUE ("GANGLION CYST"), LEFT WRIST, EXCISION: - GANGLION CYST.
The sections show fibroadipose tissue with cyst-like spaces surrounded by fibrous tissue. There are no villous projections into the cyst-like spaces. Focal myxoid areas are present with rare bland spindle cells. There is no nuclear atypia and no mitotic activity is appreciated. Dense connective tissue consistent with tendon is present focally.
The sections show cyst-like spaces surrounded by fibrous tissue. There are no villous projections into the cyst-like spaces. Focal myxoid areas are present with rare bland spindle cells. There is no nuclear atypia and no mitotic activity is appreciated. Dense connective tissue consistent with tendon is present focally. Benign glands are present.
- URL: http://emedicine.medscape.com/article/1243454-overview. Accessed on: 8 February 2012.
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