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Chen X, Hu D, Gao W, Wu Q, Qin X, Wang Z, Xu Y, Chen D, Li N, Weng G. Repeated misdiagnosis of small intestine bronchogenic cyst: a case report. Front Oncol 2024; 14:1259335. [PMID: 38322412 PMCID: PMC10844881 DOI: 10.3389/fonc.2024.1259335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 01/02/2024] [Indexed: 02/08/2024] Open
Abstract
Bronchogenic cysts are uncommon congenital malformations of the respiratory system. These cysts can be categorized as intrapulmonary, mediastinal, or ectopic. Ectopic bronchogenic cysts, which lack distinctive clinical and imaging features, are particularly challenging to diagnose. This study presents a 48-year-old woman having a small intestinal bronchogenic cyst. She was repeatedly misdiagnosed as having an ovarian chocolate cyst or a cystic mass of bladder origin three years ago. However, no cyst was found during the operation. Half a year prior to presenting at our hospital, the patient developed frequent urination, prompting her to seek further treatment. We eventually discovered a cyst in the small intestine. The histological evaluation of the specimen showed a bronchogenic cyst. Small intestine bronchogenic cysts are extremely rare and easily misdiagnosed. It should be considered as one of the differential diagnoses of pelvic cysts. Particularly, when intraoperative exploration of the pelvic cavity fails to detect any cysts, consideration should be given to the possibility of small intestine bronchogenic cysts.
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Affiliation(s)
- Xiaodong Chen
- Department of Urology, Ningbo Urology and Nephrology Hospital, Ningbo, Zhejiang, China
| | - Danfei Hu
- Department of Radiation Therapy, Ningbo Medical Treatment Center Lihuili Hospital, Ningbo, Zhejiang, China
| | - Wenbo Gao
- Department of Urology, Ningbo Urology and Nephrology Hospital, Ningbo, Zhejiang, China
| | - Qihang Wu
- Department of Urology, Ningbo Urology and Nephrology Hospital, Ningbo, Zhejiang, China
| | - Xiangcheng Qin
- Department of Urology, Ningbo Urology and Nephrology Hospital, Ningbo, Zhejiang, China
| | - Zhichao Wang
- Department of Urology, Ningbo Urology and Nephrology Hospital, Ningbo, Zhejiang, China
| | - Yangkai Xu
- Department of Urology, Ningbo Urology and Nephrology Hospital, Ningbo, Zhejiang, China
| | - Dong Chen
- Department of Urology, Ningbo Urology and Nephrology Hospital, Ningbo, Zhejiang, China
| | - Nan Li
- Department of Urology, Ningbo Urology and Nephrology Hospital, Ningbo, Zhejiang, China
| | - Guobin Weng
- Department of Urology, Ningbo Urology and Nephrology Hospital, Ningbo, Zhejiang, China
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Gu X, Zhu L, Li Y, Yin B, Wang Z. Imaging Findings and Misdiagnosis of Bronchogenic Cysts: A Study of 83 Cases. J Belg Soc Radiol 2023; 107:81. [PMID: 37869449 PMCID: PMC10588525 DOI: 10.5334/jbsr.3214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/12/2023] [Indexed: 10/24/2023] Open
Abstract
Objective We characterize computed tomography (CT) and magnetic resonance imaging (MRI) features of bronchogenic cysts (BCs) and analyze misdiagnosis. Methods The retrospective study consisted of 83 patients with BCs. CT and MRI images were assessed for mass location, maximum diameter, density, calcification, signal intensity, and enhancement pattern. Eighty-three patients underwent plain CT in which 53 underwent enhanced CT. Thirteen patients received both plain and enhanced MR, and only one received just a plain MR. Results Eighty-three masses were all solitary, with 71 having a roundish morphology, and twelve having a lobulated or irregular morphology. Sixty-six masses are mediastinal type, four are intrapulmonary type, and 13 are ectopic type. Calcification occurred in 14 lesions. On plain CT, 13 lesions displayed water-like attenuation (-20-20 Hu), and 70 showed soft-tissue attenuation (≥21 Hu). On T1WI, eight masses were hyperintense, three were isointense, and three were hypointense. Fourteen masses were hyperintense on T2WI and (Apparent Diffusion Coefficient) ADC sequence. On (Diffusion Weighted Imaging) DWI, six masses were hypointense and eight were hyperintense. Enhanced T1WI showed seven cases were unenhanced, while six were marginally enhanced. Twenty cases were misdiagnosed as thymomas, eleven as neurogenic tumors, six as lymphangiomas, and two as lung cancer. Five cases were misdiagnosed as other diseases. Patients with BCs underwent MR (42.9%) had a lower rate of misdiagnosis than those who underwent CT alone (53.0%). Conclusion The imaging findings of BCs in the chest are generally consistent. Misdiagnosis occurs frequently when CT attenuation values exceed 20 Hu. Diagnostic accuracy of BCs tends to improve with preoperative MR examination.
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Affiliation(s)
- Xiaoyu Gu
- Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210009, China
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Li Zhu
- Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210009, China
| | - Yingming Li
- Department of Medical Imaging, Yantai Yuhuangding Hospital, Yantai 264000, China
| | - Bo Yin
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Zhongqiu Wang
- Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210009, China
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Li Y, Wang S, Tai J, Zhang J, He L, Zhang N, Zhang X, Liu Q, Sun N, Ni X. Surgical Experiences of Pediatric Cervical Bronchogenic Cysts: A Case Series of 6 Patients. EAR, NOSE & THROAT JOURNAL 2023; 102:121-125. [PMID: 33491486 DOI: 10.1177/0145561320982194] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES Bronchogenic cyst is a rare congenital disease which occurs especially in the neck region. This report presents 6 cases of bronchogenic cysts and discusses the diagnosis and surgical experience of this anomaly. METHODS A retrospective study of 6 pediatric patients with cervical bronchogenic cysts treated in our hospital during 2016 to 2019 was performed. We recorded and analyzed the clinical data of the patients, including age, symptoms, imaging findings, surgical procedure, and complications. RESULTS All patients underwent surgical excision. The chondroid tissues were found at the base of cysts which clung to the trachea in 5 patients and completely removed by surgery without recurrence. One patient showed recurrence due to residual cartilage after the first surgery, and the second surgery was required to resect the remaining cartilage. During the surgery, the recurrent laryngeal nerve (RLN) detector was used, which confirmed that all the RLNs clung to the side wall of cysts. All cases were cured without complications. CONCLUSIONS Although rare, bronchogenic cysts should be considered in the differential diagnosis of peritracheal masses in children. Complete resection of the bronchogenic cysts, including the cartilages at the base, is vital in preventing recurrence. The RLN must be protected during the surgery.
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Affiliation(s)
- Yanzhen Li
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Xicheng, Beijing, People's Republic of China
| | - Shengcai Wang
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Xicheng, Beijing, People's Republic of China
| | - Jun Tai
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Xicheng, Beijing, People's Republic of China
| | - Jie Zhang
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Xicheng, Beijing, People's Republic of China
| | - Lejian He
- Department of Pathology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Xicheng, Beijing, People's Republic of China
| | - Nan Zhang
- Department of Pathology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Xicheng, Beijing, People's Republic of China
| | - Xuexi Zhang
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Xicheng, Beijing, People's Republic of China
| | - Qiaoyin Liu
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Xicheng, Beijing, People's Republic of China
| | - Nian Sun
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Xicheng, Beijing, People's Republic of China
| | - Xin Ni
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Xicheng, Beijing, People's Republic of China
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Almatrafi S. Intramural Bronchogenic Cysts in the Pediatric Population. Cureus 2020; 12:e7111. [PMID: 32257658 PMCID: PMC7100854 DOI: 10.7759/cureus.7111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
A bronchogenic cyst is a rare congenital malformation. It occurs due to the development of buds in any part of the tracheobronchial area. It can also lead to fatal complications, especially in the early stages of life. However, data on its diagnosis and treatment are scarce, owing to the rarity of the disease. This review article aimed at evaluating the literature on the manifestations of intramural bronchogenic cysts in the pediatric population. Medical databases were examined thoroughly to explore eligible articles for inclusion. Twenty-three articles appeared in the search result. The produced reports were evaluated against the predecided inclusion criteria. After reviewing the literature, eight articles were eligible for inclusion in this review. The included articles were published between 2000 and 2020. An intramural bronchogenic cyst is a rare condition that should not be neglected in a differential diagnosis. Surgical excision is currently the recommended management strategy. Further extensive studies about the management of the complications of intramural bronchogenic cysts are needed.
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Affiliation(s)
- Sharif Almatrafi
- Otorhinolaryngology, Head & Neck Surgery, College of Medicine, Prince Sattam Bin Abdulaziz University, Riyadh-Al Kharj, SAU
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