Gastric bronchogenic cysts: A case report and literature review

Young patient with a giant gastric bronchogenic cyst: A case report and review of literature

BACKGROUND

Gastric bronchogenic cysts (BCs) are extremely rare cystic masses caused by abnormal development of the respiratory system during the embryonic period. Gastric bronchial cysts are rare lesions that were first reported in 1956; as of 2023, only 33 cases are available in the PubMed online database. BCs usually have no clinical symptoms in the early stage, and imaging findings also lack specificity. Therefore, they are difficult to diagnose before histopathological examination.

CASE SUMMARY

A 34-year-old woman with respiratory distress presented at our hospital. Endoscopic ultrasound revealed an anechoic mass between the spleen, left kidney and gastric fundus, with hyperechogenic and soft elastography textures and with a size of approximately 6.5 cm × 4.0 cm. Furthermore, a computed tomography scan demonstrated high density between the posterior stomach and the spleen and the left kidney, with uniform internal density and a small amount of calcification. The maximum cross section was approximately 10.1 cm × 6.1 cm, and the possibility of a cyst was high. Because the imaging findings did not suggest a malignancy and because the patient required complete resection, she underwent laparotomy surgery. Intraoperatively, this cystic lesion was found to be located in the posterior wall of the large curvature of the fundus and was approximately 8 cm × 6 cm in size. Finally, the pathologists verified that the cyst in the fundus was a gastric BC. The patient recovered well, her symptoms of chest tightness disappeared, and the abdominal drain was removed on postoperative day 6, after which she was discharged on day 7 for 6 months of follow-up. She had no tumor recurrence or postoperative complications during the follow-up.

CONCLUSION

This is a valuable report as it describes an extremely rare case of gastric BC. Moreover, this was a very young patient with a large BC in the stomach.

Gastric cardia bronchogenic cyst with prolonged belching

A 65-year-old man presented with a 15-year history of belching, accompanied by intermittent epigastric pain. She had undergone abdominal computed tomography 5 years earlier, which showed a cystic mass in the gastric cardia (asterisk), measuring 4 cm × 3 cm in size. His symptoms worsened recently, especially when consuming stimulating food or after emotional excitement. Repeated abdominal computed tomography showed similar cystic mass in the gastric cardia (asterisk), with small quantity of peripheral calcification. Laparoscopic resection of the cystic mass was performed. Histopathologic examination confirmed the diagnosis of bronchogenic cyst, with internal coffee colored liquid and partial cyst wall calcification. The symptom of belching disappeared after surgery and the patient was feeling well at 2 months of follow-up.

Optimal resection of gastric bronchogenic cysts based on anatomical continuity with adherent gastric muscular layer: A case report

BACKGROUND

Bronchogenic cysts are congenital lesions requiring radical resection because of malignant potential. However, a method for the optimal resection of these cysts has not been completely elucidated.

CASE SUMMARY

Herein, we presented three patients with bronchogenic cysts that were located adjacent to the gastric wall and resected laparoscopically. The cysts were detected incidentally with no symptoms and the preoperative diagnosis was challenging to obtain via radiological examinations. Based on laparoscopic findings, the cyst was attached firmly to the gastric wall and the boundary between the gastric and cyst walls was difficult to identify. Consequently, resection of cysts alone caused cystic wall injury in Patient 1. Meanwhile, the cyst was resected completely along with a part of the gastric wall in Patient 2. Histopathological examination revealed the final diagnosis of bronchogenic cyst and revealed that the cyst wall shared the muscular layer with the gastric wall in Patients 1 and 2. In Patient 3, the cyst was located adjacent to the gastric wall but histopathologically originated from diaphragm rather than stomach. All the patients were free from recurrence.

CONCLUSION

The findings of this study state that a safe and complete resection of bronchogenic cysts required the adherent gastric muscular layer or full-thickness dissection, if bronchogenic cysts are suspected via pre- and/or intraoperative findings.

Retroperitoneal bronchogenic cyst with fluid‑fluid level: A case report and literature review

Bronchogenic cyst is a benign lesion with congenital dysplasia. Although the occurrence of this type of cyst is rare in the retroperitoneum, the presence of fluid-fluid levels is an even rarer phenomenon in bronchogenic cysts. Therefore, it can be easily misdiagnosed due to the lack of a universal guideline of specific imaging manifestations. The present report describes the case of a patient with a bronchogenic cyst with fluid-fluid levels whilst also performing a brief literature review to summarize the findings of previous reports on this condition. A 48-year-old male individual presented with severe lower back pain without any obvious causes. A CT scan revealed a low-density cystic mass of ~3x4x6 cm in the left front of the T12-L2 area, which originated from the left crus of the diaphragm. MRI revealed a fluid-fluid level in the cyst. Anterior thoracolumbar surgery was performed to completely resect the mass. During the surgery, it was confirmed that the cyst originated from the left crus of the diaphragm and the lesion was diagnosed to be a bronchogenic cyst by pathological analysis. The patient's symptoms improved after the surgery and no recurrence of the cyst was observed during the 3-year follow-up period. The presence of a fluid-fluid level in a retroperitoneal bronchogenic cyst is rare, particularly in the abdominal aorta and paravertebral regions, rendering it easily misdiagnosed. It may be associated with protein, hemorrhage and calcium-containing mucus deposition in the cysts. In the present study, a rare case of fluid-fluid level in bronchogenic cyst was reported and a literature review was provided.

Bronchogenic cysts with infection in the chest wall skin of a 64-year-old asymptomatic patient: A case report

BACKGROUND

Skin bronchogenic cysts are extremely rare congenital bronchocystic changes caused by the abnormal development of the trachea, bronchial trees or lung buds during the embryonic period. The first case of skin bronchogenic cysts was reported in 1945. Since then, this disease has attracted increasing attention, but due to the low incidence, its pathogenesis is still not clear.

CASE SUMMARY

Here, we report another case of skin bronchogenic cysts with infection in a 64-year-old female patient. The patient had no symptoms for more than 60 years until her chest wall was recently found to be swollen, and she felt pain and discomfort. At the same time, secretions were found on the surface of the swelling. Color Doppler ultrasound examination showed abnormal echoes in the soft tissue under the frontal chest wall, suggesting the presence of cysts. Cytological puncture resulted in about 2 mL of pus and showed the presence of more acute inflammatory cells. The final clinical diagnosis was skin cyst with infection, and surgery was carried out. The pathological results obtained after surgery showed that the cystic wall was covered with column-like cilia epithelial cells, and the interstitial structure was partially inundated with inflammatory cells. After a variety of examinations and clinical diagnoses, we finally confirmed that the patient was suffering from bronchogenic cyst.

CONCLUSION

This article not only describes the case of an elderly patient with rare skin bronchogenic cysts with infection but also provides a detailed and correct diagnosis and a successful treatment process, which is of great value for the diagnosis and treatment of the disease.

Bronchogenic cyst of the stomach: A case report and literature review

Bronchogenic cyst (BC) is a rare congenital disease with pre-embryonic intestinal malformation. BC of the stomach is rare. The present study reported on the case of a 68-year-old male who presented with a spleen and stomach space mass detected incidentally upon a routine health examination. The patient underwent laparotomy. Postoperative histopathological diagnosis confirmed BC of the stomach. Postoperative recovery was smooth and the patient is currently under follow-up. A literature review suggested that BC is a rare disease and the location of the stomach is very rare. Indications of surgical intervention remain controversial for asymptomatic cases. Owing to no specific clinical or radiologic features to define the disease profile for diagnosis, surgery may be a good choice for both diagnosis and therapy if the patient's condition permits.

Intramural bronchogenic cysts of the esophagus and gastroesophageal junction: A case report

Bronchogenic cyst is a relatively rare congenital malformation that is often identified in the mediastinum. The occurrence of bronchogenic cysts in the intramural esophagus and gastroesophageal junction is rare. The present report describes three cases of intramural bronchogenic cysts of the esophagus and gastroesophageal junction and reviews the clinicopathological features of these lesions. A 35-year-old Japanese male (Case 1), a 50-year-old Japanese woman (Case 2) and a 34-year-old Japanese man (Case 3) presented with dysphagia, pharyngeal pain and heartburn, respectively. Upper endoscopic examination revealed submucosal tumors in the esophagus (Case 1 and 2) and gastroesophageal junction (Case 3). Subsequent endoscopic examination revealed perforation of the cyst into the surface of the esophageal mucosa (Case 2). Surgical resection was performed in all cases. Histopathological examinations revealed that the submucosal cysts were covered by respiratory-type ciliated epithelium without atypia. Cartilage and bronchial glands were not observed in any of the cases. The present review of the clinicopathological characteristics of bronchogenic cysts of the esophagus and gastroesophageal junction revealed that males and females were equally affected. The median age of the patients was 34.5 years with a wide age distribution. The most common main complaint was dysphagia. A pre-operative diagnosis of bronchogenic cyst is difficult because no specific imaging features are present. As surgical resection is recommended for this lesion, recognition of the clinicopathological features of bronchogenic cysts is important for an accurate pre-operative diagnosis.

[Gastric bronchogenic cysts. An unusual location]

Bronchogenic cysts are rare benign lesions that arise during embryogenesis of the primitive proximal intestine and are located primarily in the lung. They are lined with cuboid or columnar pseudostratified and ciliated epithelium and have elastic fibers, smooth muscle, bronchial glands and cartilage in their walls. Gastric bronchogenic cysts are extremely rare with very few reported cases. Symptoms are usually caused by compression. GIST is the main differential diagnosis and the treatment is surgical resection.

Ileal bronchogenic cyst: A case report and review of literature

We herein report a rare case of ileal bronchogenic cyst that was found in a 39-year-old Chinese man. He had no symptoms and the physical examination was normal. Tumor markers were within the normal range. Abdominopelvic enhanced computed tomography showed a mass in the lower abdominal cavity and the tumor had a complete capsule. Diagnostic laparoscopy was then performed, which showed that a spheroid mass with a complete capsule was located at the antimesenteric border of the distal ileum 20 cm from the ileocecal valve, measuring 6.0 cm × 6.0 cm × 5.0 cm. Considering that the malignancy of the tumor cannot be ruled out, and there is a risk of rupture during laparoscopic surgery, the patient was converted to an open surgery. Partial resection of the ileum with the tumor was performed, followed by a side-to-side anastomosis. The tumor was gray-red in color, filled with grayish yellow mucus and had no septum. The postoperative pathology revealed that the cystic wall was lined by pseudostratified ciliated columnar epithelium without cellular atypia. The wall consisted of bronchial mucous glands and smooth muscle fibers, and no abnormalities were found in adjacent ileum tissues. Thus, a diagnosis of bronchogenic cyst of the ileum was made.

Large bronchogenic cyst of stomach: A case report

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Bronchogenic cysts of the stomach are rare congenital benign cysts arising as an abnormal budding from primitive tracheobronchial tree.

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They are lined by pseudostratified columnar ciliated epithelium and contain smooth muscle fibers, mucous glands and/or cartilage in the cyst wall.

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They are most frequently located close to the gastroesophageal junction or gastric cardia and misdiagnosed as gastrointestinal stromal tumor on preoperative imaging.

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Surgical excision is the most preferred treatment as it helps in relieving the symptoms as well as confirms the diagnosis.

Introduction

Bronchogenic cysts are congenital cysts arising as an abnormal budding from primitive tracheobronchial tree. They are lined by pseudostratified columnar or cuboidal ciliated epithelium and contain smooth muscle fibers, submucosal bronchial glands and/or cartilage. They are most frequently located in the mediastinum or the lung parenchyma. Intramural occurrence of bronchogenic cyst in the gastric wall is very rare.

Presentation of case

We present a case of 65-year-old lady with a 7 × 8 cm lesion in the gastric cardia suspicious of gastrointestinal stromal tumor. Because of the large size, total gastrectomy with Roux-en-Y esophagojejunal anastomosis was performed. The postoperative course was uneventful. Histopathological examination revealed a sub-mucosal cyst lined by PCCE with presence of smooth muscle fibers and focal mucous glands. Final diagnosis of bronchogenic cyst was made. On the last follow up at one year, she was symptom free.

Discussion

On extensive Medline/Pubmed search, only 38 cases of gastric bronchogenic cysts were found to be reported till date. They are typically located in the posterior gastric wall close to the gastric cardia. On radiological imaging, they appear as well defined intramural cystic lesion without any characteristic features. Surgical resection is considered in symptomatic cases or in case of diagnostic dilemma.

Conclusion

Gastric bronchogenic cysts often mimic gastrointestinal stromal tumor on preoperative imaging. They should be included in the differential diagnosis while dealing with an intramural gastric lesion close to the cardia or gastroesophageal junction.