Nabothian Cyst of the Cervix on Radiology Reports: What It Means

A nabothian cyst is one of the most common benign findings seen on pelvic ultrasound. It often appears during a routine imaging study done for other reasons such as pelvic pain, abnormal bleeding, or pregnancy evaluation. Nabothian cysts are harmless, fluid-filled pockets that form when tiny mucus-producing glands on the cervix become blocked. They are not infections, not precancerous, and almost never require any treatment. 

What a Nabothian Cyst Is

A nabothian cyst forms when tiny mucus glands on the surface of the cervix get blocked. The trapped mucus forms a small pocket of fluid. Many people have more than one. They are most often found by chance during pelvic ultrasound.

How It Looks on Ultrasound (Imaging Features)

Transvaginal ultrasound is the most common way we see these. Typical features:

• Location: Within the cervix, often near the canal (endocervix).

• Shape: Round or oval with sharp, smooth borders.

• Content: Clear fluid, so the cyst looks anechoic (black).

• Wall: Very thin, no nodules on the inside.

• Posterior acoustic enhancement: The area behind the cyst looks slightly brighter—classic for simple fluid.

• Doppler: No internal blood flow.

Sizes range from a few millimeters to a couple of centimeters. Multiple small cysts are normal.

Why Radiologists Call It Benign

Imaging signs of a simple cyst are key. A thin-walled, purely fluid-filled structure without internal echoes or blood flow is the classic benign pattern. We also match the appearance to the location: a simple cyst inside the cervix has a very limited list of causes, and nabothian cyst is the top one.

When We Add a Comment or Recommendation

Most of the time, the report simply names the finding and states that it is benign. Recommendations are rare. A radiologist may suggest follow-up or a gynecology visit only if there are unusual features, such as:

• Internal solid parts or thick septations

• Irregular or thick walls

• Internal blood flow on Doppler

• Rapid growth or symptoms (persistent pain, unusual bleeding, pressure)

These features are not typical of nabothian cysts and may trigger further evaluation to be safe.

Symptoms: Usually None

Most people feel nothing. If symptoms occur, they are usually mild—such as a sense of fullness or light spotting—often due to other common cervical issues rather than the cyst itself. Very rarely, a large cyst can cause pressure or bleeding.

What It Means for Your Health

• Not cancer: Nabothian cysts are not precancerous and do not become cancer.

• No impact on fertility: They usually do not affect fertility or pregnancy.

• No effect on Pap tests: They rarely interfere with cervical screening.

Why They Appear

The cervix constantly renews its surface. After childbirth, inflammation, or normal hormonal changes, new cells can cover a tiny gland opening and trap mucus. That’s all it takes to form a nabothian cyst. People who have had childbirth or inflammation may have more of them.

How We Tell It Apart from Other Things

Radiologists use pattern recognition:

• Nabothian cyst: Simple, thin-walled, no blood flow, in the cervix.

• Tunnel clusters (benign gland changes): Groups of tiny cysts clustered together; still benign.

• Gartner duct cyst: Usually along the vaginal wall, not inside the cervix.

• Adenoma malignum (very rare cervical cancer subtype): Multiple deep cysts with enhancing septa or solid components; if suspected, MRI and gynecology referral are important. This is uncommon and does not match the typical simple nabothian cyst look.

MRI and CT: When They Come Into Play

Ultrasound is usually enough. If MRI is done for another reason, a nabothian cyst typically shows:

• T2-weighted MRI: Bright fluid signal.

• T1-weighted MRI: Usually dark, unless there is protein or blood, which can appear brighter.

• No solid enhancement: The thin wall may enhance minimally, but there should be no enhancing solid parts inside.

CT is less helpful for small cervical cysts but may show a tiny, fluid-density focus in the cervix if the scan includes that region.

Do Nabothian Cysts Need Treatment?

Usually not. No medication is needed. No drainage is needed. If a cyst is very large and clearly causing symptoms, a gynecologist can discuss simple office procedures. This is uncommon.

Follow-Up: Do I Need Another Ultrasound?

If the appearance is classic and you have no symptoms, no follow-up is usually needed. Your radiologist may suggest follow-up only if the cyst is large, looks atypical, or if you have related symptoms that the imaging can help clarify.

Pregnancy and Nabothian Cysts

They are commonly seen during pregnancy ultrasounds and remain benign. They do not harm the baby.

Practical Takeaways

• A nabothian cyst is a benign, mucus-filled cervical cyst.

• On ultrasound it looks like a simple, thin-walled, fluid-filled bubble with no internal blood flow.

• No treatment or follow-up is needed in most cases.

• Unusual features or bothersome symptoms may lead to MRI or gynecologic evaluation, mainly to confirm that the cyst is simple and to rule out rare mimics.

Conclusion

A nabothian cyst on your ultrasound report is a routine, benign finding. It looks like a simple fluid bubble in the cervix and almost never needs treatment or follow-up. If the imaging shows typical features and you feel well, you can be reassured and continue with your normal gynecologic care.

References

https://www.ncbi.nlm.nih.gov/books/NBK559047/

https://www.health.harvard.edu/a_to_z/nabothian-cysts-a-to-z

https://ajronline.org/doi/10.2214/AJR.09.3619