# Multiple Nabothian Cysts and Tunnel Clusters Clinically Mimicking Lobular Endocervical Glandular Hyperplasia: A Case Report

## TL;DR

A 48-year-old woman's cervical cysts initially suggested a cancer precursor but were later found to be benign, highlighting the difficulty in distinguishing similar-looking cervical conditions.

## Contribution

This case report highlights the potential for Nabothian cysts and tunnel clusters to mimic lobular endocervical glandular hyperplasia in imaging.

## Key findings

- MRI findings initially suggested lobular endocervical glandular hyperplasia (LEGH).
- Pathological analysis confirmed Nabothian cysts and tunnel clusters instead of LEGH.
- The case emphasizes the need for careful differentiation between benign and potentially precancerous cervical lesions.

## Abstract

This report describes a 48-year-old woman who presented with multiple cystic lesions in the uterine cervix. Magnetic resonance imaging (MRI) showed multiple large and small cysts in the uterine cervix, which raised lobular endocervical glandular hyperplasia (LEGH) as a differential diagnosis, because a cosmotic and microcystic pattern characteristic of LEGH might be suggested. However, pathological examination of the conization specimen revealed the simultaneous occurrence of superficial and deep Nabothian cysts (NCs) and tunnel clusters (TCs), without evidence of LEGH. LEGH is a potential precursor lesion to gastric-type adenocarcinoma (GAC) and should be distinguished from NCs and TCs, which do not typically require follow-up. This case highlights the challenges in the clinicoradiological differentiation between benign cervical lesions and LEGH. Clinicians and pathologists should be aware of the possibility of coexisting NCs and TCs mimicking LEGH in imaging studies.