Final Findings
Jessie Z -
Greetings to everyone,
I believe this is the final blog post, and I’m happy to share some of the final lessons I’ve learned during this internship. While my research primarily focuses on a radiology perspective, I would still like to highlight the importance of pathology. Before my research with Mayo Clinic physicians, studying the nodules and tumors pathologically was their only way of diagnosing the condition Bartholin gland hyperplasia. Now that we have provided MRI evidence that can help reliably diagnose this condition, pathology still remains the gold standard. Additionally, guidelines suggest that a biopsy should occur before observation. Biopsy should be performed of a mass of any size if any of the following are present: solid component, wall that is fixed to surrounding tissues, mass that is persistent despite treatment, patient is postmenopausal.
As established by Koenig and Tavassoli in 1998, the histologic criteria for BGH includes benign proliferation of glandular tissue, preserved lobular architecture, increased number of secretory acini, and a normal architectural relationship of the acini and the draining duct. These terms are very confusing at first glance, so I will break them down. Preserved lobular architecture refers to the fact that the overall structure of the gland, including the lobules, is maintained. Normal duct-acinar relationship means the ducts and acini (the secretory units) maintain their typical arrangement. This will be more clear in the histology images I provide in my presentation. Increased number of acini means there is a noticeable increase in the number of secretory cells that produce mucus. Last but not least, as you may know, benign nature implies that the growth is non-cancerous and does not invade surrounding tissues. I’m excited to present the MRI scans which not only aligns with the histologic criteria but also presents additional information. For example, MRI can provide evidence of BGH’s benign nature through showing progressive homogenous enhancement after contrast injection and no abnormal diffusion signal.
If you are interested in learning more about these findings, you are welcome to watch my presentation on May 3rd!
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