Vulvar Bartholin Gland Lesions: A Clinicopathologic Study of 111 Cases
Shaojiang Zheng, Soo-Jin Jung, Jae Ro, Steven Shen. Hainan Medical College, Haikou, Hainan, China; College of Medicine of Inje University, Busan, Republic of Korea; Methodist Hospital and Weill Medical College of Cornell University, Houston, TX
Background: Bartholin gland is the major vulvar vestibular gland that is normally impalpable and gradually involutes after the age of 30 years. It is histologically composed of simple tubuloalveolar glands with mucin producing alveoli, reminiscent to Cowper s glands in men and minor salivary glands, drain into a central ducts mostly lined by transitional epithelium. Other than Bartholin cyst, very few benign lesions are reported in the literature. This study reviewed the clinicopathologic features of 111 cases of Bartholin gland lesion.
Design: Pathology reports and all available slides of 111 cases of vulvar Bartholin gland lesions from a single Institution (1990-2011) were reviewed. Clinicopathologic features including age, presenting sign or symptoms, extent of surgery, lining epithelium, inflammation, and histopathologic changes of Bartholin gland were evaluated.
Results: Of the 111 patients, the mean age was 41.4 years (range 18-82). The most common presenting symptom was cystic or mass lesion. Surgery ranged from simple biopsy to resection. A cyst was present in 101 cases (91%) (intact 79, ruptured 22). A lining epithelium was identified in 93 of 111 (83.8%) cases. Acute inflammation or abscess was identified in 43 of 111 (38.7%) of the cases. The most common cystic lining epithelium was transitional (33.3%), mixed transitional and squamous (33.3%), squamous (23.7%), or mucinous (9.7%). Bartholin mucous glands were identified in 46 (41%) of cases, with 9 cases of hyperplasia and 1 case of adenoma. In addition, one case of myoepithelioma, adenoid cystic carcinoma, invasive squamous cell carcinoma, and severe squamous dysplasia extending to the Bartholin gland was identified.
Conclusions: Bartholin gland lesion commonly presents as cyst or mass in middle aged women (average of 41.4 years). The most common cystic epithelial linings are squamous, transitional or mixed type. Acute inflammation or abscess is a frequent associated finding in Bartholin cyst, which may be an important histogenetic factor for the cyst formation. Besides Bartholin cyst, other pathologic processes including rare adenoid cystic carcinoma and squamous carcinoma also occur.
Category: Gynecologic & Obstetrics
Tuesday, March 5, 2013 1:00 PM
Poster Session IV # 233, Tuesday Afternoon