Gynaecology for students and practitioners . The ostium of the tube is attached to the outer surface of thecyst, and the ovarian fimbria runs from the tubal ostium to the latter structure is generally quite separate and distinct, but in thecase of very large cysts it may become greatly thinned and flattenedout, and incorporated in their walls. The pedicle of a fimbrial cyst is composed of that portion ofthe broad ligament w^hich is not occupied by the cyst. It followsthat only cysts of comparatively small size can be said to possessa pedicle [see Fig. 401). When large enough to occup
Gynaecology for students and practitioners . The ostium of the tube is attached to the outer surface of thecyst, and the ovarian fimbria runs from the tubal ostium to the latter structure is generally quite separate and distinct, but in thecase of very large cysts it may become greatly thinned and flattenedout, and incorporated in their walls. The pedicle of a fimbrial cyst is composed of that portion ofthe broad ligament w^hich is not occupied by the cyst. It followsthat only cysts of comparatively small size can be said to possessa pedicle [see Fig. 401). When large enough to occupy all thespace between the peritoneal folds of the broad ligament the cystbecomes sessile. The cyst is unilocular and has a very thin, but comparatively strong, 700 GYNECOLOGY wall which is loosely attached to the investing peritoneum. Theinner surface is smooth excepting for the occasional presence of a fewwarty growths {see Fig. 401). Microscopically the wall is seen tocontain connective tissue and muscle-fibres, and the lining consists. Fig. 402. Fimbriae Cyst. The section shows the scanty epithelial lining consisting of imperfectly preserved cubical cells. A is merely an inclusion of lining-epithelium due to the fusion of two fibrous papillomata. of columnar ciliated epithelium. The contents consist of a limpidalkaline fluid, nearly or quite as colourless as water, and having alow specific gravity (1004-1006) ; it contains a faint trace of albumenand very rarely pseudomucin. Clinical Features. Fimbrial cysts probably never develop beforepuberty, they grow very slowly, and may exist for many years withoutcausing serious symptoms. Large cysts, after opening up the broad ligament, may burrowdownwards into the paravaginal and pararectal connective tissues,displacing the uterus upwards and forwards or to one or other may also elevate the peritoneum and open up the mesosigmoid ormesocsecum, reaching by this retroperitoneal route high up into theabdomen. CYSTS ARISING IN
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
