A Text-book of Diseases of Women

by Charles B. Penrose

The contents of a glandular cyst vary greatly, not only in different cysts, but in the different cavities of the same cyst. Pseudomucin, a peculiar mucoid substance excreted from the lining gland cells, is a most important constituent of the contents of this cyst, and is almost characteristic.

The fluid may be thin and colorless; it may resemble thick, tenacious mucus; it may be oily or syrupy in consistency; or it may resemble transparent jelly. It may be colorless, yellow, apple-green, or brown or black from the presence of decomposed blood. As a rule, the fluid becomes thinner as the cyst increases in size and age. The change is probably due to the alteration that takes place in the character of the lining membrane under the influence of continuously increasing pressure.

The specific gravity of the fluid varies from 1010 to 1050.

Fig. 167.—An oöphoritic glandular cyst. The section shows the remains of an atrophied septum, a number of follicular cysts in the wall, and to the right a group of mucous retention-cysts.

As glandular cysts of the ovary originate in the free border of the gland, they are in the great majority of cases intra-peritoneal in their growth. They grow into the peritoneal or the abdominal cavity; they do not push aside layers of peritoneum, like the cysts that originate between the folds of the broad ligament, and which are extra-peritoneal in their development.

Very rarely glandular cysts of the ovary have been found that grew between the layers of the broad ligament and were extra-peritoneal in development. It may be that in such cases the ovary itself had occupied an abnormal position.

The shape of the ovary is very early destroyed by a glandular cyst. The ovarian tissue is incorporated with, and is spread throughout the cyst-wall. In small tumors the remains of the hilum may be found at the pedicle. In no case is the body of the ovary discoverable as a distinct structure lying upon the surface of the cyst.

The pedicle of the cyst is composed of the ovarian ligament, the upper portion of the broad ligament, and the Fallopian tube. These structures are all more or less thickened and lengthened as a result of the traction and of the altered nutrition produced by the growing cyst.

The vessels of the pedicle that are derived from the ovarian and uterine arteries are of various size. The arteries rarely exceed the size of the radial artery.