Naboth kisti ve benign servikal kistik lezyonlar

Özet

Naboth kistleri, endoservikal bez salgılarının retansiyonuyla oluşan ve genellikle asemptomatik olan lezyonlardır; görüntülemede tesadüfen saptanabilir. Görüntülemede BT, yetersiz yumuşak doku çözünürlüğü nedeniyle kist içeriğini ve glandüler mimariyi güvenilir biçimde karakterize etmede sınırlıdır. Çok odacıklı ya da serviksi genişleten bir lezyonda solid doku, infiltratif büyüme ve çevre yayılımı bulunup bulunmadığını aramak, benign kist görünümüne erken bağlanmayı önler. Derin yerleşimli glandüler malignitenin kistik benign lezyon sanılması tanının gecikmesine yol açabilir.

Faz ve pencere

Kontrastsız

Servikal stromada tek veya çok sayıda mukus içerikli kistik odak görülebilir. BT, yetersiz yumuşak doku kontrastı nedeniyle servikal kist duvarını veya olası solid bileşeni güvenilir biçimde değerlendiremez.

Önerilen pencereler: Batın (G 400 / M 50), Yumuşak doku (G 400 / M 40).

BT bulguları

• Servikal stromada tek veya çoklu mukus içerikli kistik odaklar görülebilir.
• Naboth kistleri servikal stromada tek veya çok sayıda mukus dolu kistik odak olarak görülebilir; BT, yetersiz yumuşak doku kontrastı nedeniyle bu odakları güvenilir biçimde karakterize edemez.
• Yüzeyel ve dağınık yerleşimli kistler, servikal kanal eksenini genellikle belirgin biçimde itmez.
• Derin Naboth kistleri çok odacıklı görünüm alabilir ve tünel kümeleri (tunnel clusters) ile birlikte bulunabilir.
• İnfiltratif servikal stromal doku, düzensiz kontur ya da solid-kistik kitle basit retansiyon kisti için tipik değildir.
• Solid bileşen ya da düzensiz sınır malignite kuşkusunu artırır; BT servikal lezyonlarda yeterli yumuşak doku kontrastı sağlamaz.
• Uterin kaviteyle yumuşak doku sapı üzerinden devam eden servikal kitle, aşağı prolabe olmuş uterin tümörü (leiomyom dahil) düşündürebilir.
• İlk değerlendirmede ultrasonografi kullanılır; kompleks veya belirsiz servikal lezyonların karakterizasyonunda MRG, yüksek yumuşak doku kontrastı nedeniyle tercih edilir.

Normalde

Serviks, uterusun alt ve daralmış bölümüdür. Aynı aksiyel veya sagittal düzeyde kistik odağın servikal stromaya göre yerini, kanalın yer değiştirmesini ve serviks dış konturunun genişleyip genişlemediğini karşılaştırın.

Ayırıcı tanı

Lobüler endoservikal glandüler hiperplazi (LEGH), kümeli mikrokistik veya kozmos paterni gösterebilir; lezyonun servikal kanala göre konumu ve kanal deviasyonu MRG’de değerlendirilir.

Mide tipi endoservikal adenokarsinom kistik veya kistik-solid görünebilir ve infiltratif büyüyebilir; BT’de yayılımın kapsamı olduğundan az değerlendirilebilir.

Servikal leiomyom, büyük bir pelvik kitle oluşturabilir.

Servikal endometriozis benign servikal lezyonların ayırıcı tanısında yer alır; BT, pelvik lezyonlarda yetersiz yumuşak doku kontrastı nedeniyle özgül karakterizasyon sağlamaz.

Tuzaklar

• Büyük Naboth kistleri malign kitleyi taklit edebilir; solid bileşen, düzensiz veya belirsiz sınırlar ve kontrastlanma potansiyel maligniteyi düşündüren özelliklerdir.
• Mide tipi endoservikal adenokarsinom bazı olgularda kistik veya kistik-solid görünebilir; yalnızca kistik görünüm maligniteyi dışlamaz.
• Pelvik BT’nin yumuşak doku çözünürlüğü küçük mural odakları ve glandüler mimariyi güvenilir biçimde göstermez; şüpheli kompleks lezyonun karakterizasyonu MRI ile yapılır.
• Endoservikal kanal içindeki sıvı, stromal kist gibi algılanabilir; sagittal planda sıvının kanal boyunca devam edip etmediğini izleyin.

Kendini dene

1. Servikste mukusla dolu tek ya da birden fazla kistik odakla tanımlanan lezyonun adı nedir?

   • Naboth kisti
   • Serviksin düz kas tümörü
   • Gastrik tip müsinöz karsinom
   • Serviksin ektopik endometriyal dokusu
   Cevabı göster

   Naboth kisti. Naboth kistleri servikste tek ya da birden fazla mukus dolu kistik yapı olarak görülebilir.

2. Kistik görünümüne rağmen servikal stromada invaziv büyüme gösterebilen lezyon hangisidir?

   • Gastrik tip müsinöz karsinom
   • Basit retansiyon kisti
   • Serviksin düz kas tümörü
   • Endoservikal tünel kümeleri
   Cevabı göster

   Gastrik tip müsinöz karsinom. Mide tipi endoservikal adenokarsinom invaziv bir tümördür; bazı olguları görüntülemede kistik görünebilir.

İlgili konular

• Tesadüfi adneksiyel kist veya kitle

Kaynaklar

Bu sayfadaki 34 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla otomatik olarak karşılaştırıldı; 11 cümle bu karşılaştırmada düzeltildi (2026-10-09).

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Eğitim amaçlıdır; hasta başında tanı ve tedavi kararının yerine geçmez, tıbbi tavsiye değildir. Metinler yapay zekâ desteğiyle yazıldı ve otomatik bir adımda kaynak alıntılarıyla karşılaştırıldı; bu bir tıbbi doğrulama değildir ve içerik uzman radyolog incelemesinden geçmedi. Klinik kararlarda güncel kılavuzları, kurum protokollerini ve radyoloji raporunu esas alın.