(Gustav Ludwig Thornwaldt, 1843-1910, German physician),(also called bursa pharyngea), a cystic notochordal remnant in the posterior nasopharyngeal wall, present in about 3% of the population. The cyst is located in the midline, between the prevertebral muscles. Most are asymptomatic, but they may occasionally cause nasal discharge, halitosis or other symptoms. They may become infected, causing prevertebral muscle spasm and a foul-smelling nasal discharge. A Tornwaldt's cyst appears as a hypodense cystic lesion on CT images; on MRI, the signal intensity is often rather high on T1-weighted images, presumably because of a high protein content (Fig. 1). The differential diagnosis is a retention cyst in the nasopharyngeal mucosa.
02-08-2005, 05:59 PM
I received a copy of my cervical MRI today. This is what it says:
Mild adenoidal hypertrophy as well as a small T2 heyperintense area within it, possibly representing a Thornwaldt cyst.
I tried to research Thornwaldt cyst, but can't find any usefull information. Does anyone have any experience with what this could be?
severe fatigue, pain in shoulders, neck, head and face, tingling on left side of body (leg and arm), left leg gives out at least 4-6x per month, gait problems, balance problems, cognitive inability (forget where I am or what I am doing or the best one...how to put my manual transmission car in park and ended up running into my house???), choking problems when I eat/drink (this is new...within the last 2 months) body temperature always at 96.7 (sometimes cooler but never higher than 97.1).
Thanks in advance for your help.
02-08-2005, 08:21 PM
here is what I was able to find.
Discussion: A Tornwaldt’s (or Thornwaldt’s) cyst is a benign developmental lesion that is generally located on the posterior wall of the nasopharynx on the midline. There is no sex differentiation and the peak occurrence is in patients 15-30 years old. It is related to the embryogenesis of the notochord. During development of a cyst, the notochord comes into contact with the endoderm of the primary pharynx before it reaches the prechordal plate. As a result, there is a small outpouching of pharyngeal mucosa directed toward the brain. If there is an adhesion that develops between the notochord and the endoderm when the notochord retracts into the clivus and cervical spinal column, then a small portion of nasopharyngeal mucosa is carried with it, forming a midline diverticulum, which is lined with pharyngeal mucosa. When the patient develops pharyngitis, the orifice of the diverticulum swells and subsequently closes, forming a cyst. The contents of a cyst are generally high in protein and anaerobic bacteria. Because of this, a Tornwaldt’s cyst appears bright on both the T1W and T2W MRI images. Patients with cysts are generally asymptomatic and need not be treated. Several factors, such as trauma, can however cause the pressure inside the cyst to increase and make the patient symptomatic. When the pressure is increased, the cyst bursts and releases the anaerobic contents into the nasopharynx . Symptoms are upper respiratory tract infection, nasal obstruction, halitosis, a feeling of ear fullness and prevertebral muscle spasms. Treatment of symptomatic cysts may involve using intraoral devices or surgical removal for chronically infected and painful cysts.
I figured since no one had any comments, then it must be a rare cyst. Of course this can only answer for some of my symptoms, but that in itself is a positive for me.