KEY FACTS
Terminology
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Mucus-filled cystic dilatation of endocervical gland
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Tunnel cluster: Type of nabothian cyst characterized by complex multicystic dilatation of endocervical glands
Imaging
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Circumscribed, superficial, simple unilocular cyst in cervix
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Imperceptible thin wall
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Posterior acoustic enhancement
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Average size: 10-15 mm, rarely > 4 cm
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Often multiple
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May distort endocervical canal or enlarge cervix
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Can have proteinaceous debris producing low-level echoes
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Rare septations
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Can mimic multicystic mass when multiple
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Absence of internal or peripheral flow on color Doppler
Top Differential Diagnoses
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Adenoma malignum (minimal deviation adenocarcinoma)
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Endocervical hyperplasia
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Uterine cervicitis
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Cystic endometrial polyp
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Abortion in progress
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Cervical ectopic pregnancy
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Cervical cancer
Pathology
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Most common pathologic process of cervix: Healing process of chronic cervicitis
Clinical Issues
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Incidental finding on imaging or examination, rarely symptomatic from infection or mass effect
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More common in women who have had children
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Treatment is rarely necessary
Diagnostic Checklist
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Requires further evaluation with MR if
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Solid components
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Copious vaginal discharge
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Deep cervical invasion
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Scanning Tips
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Use color Doppler if cyst appears potentially solid
with posterior acoustic enhancement 
, separate from the endocervical canal 
.
at the lateral margin of the cervix. Real-time imaging helped confirm the location within the cervical stroma; however, this image demonstrates the potential for misdiagnosis as an ovarian follicle.
with internal debris. There is posterior acoustic enhancement 
. Tiny nabothian cysts 
are noted near the endocervical canal 
.
with homogeneous internal echoes, in addition to multiple smaller nabothian cysts 
. The cervical canal is minimally displaced but remains visible 
.
