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Malik A, Naseer QA, Iqbal MA, Han SY, Dang SC. Retroperitoneal bronchogenic cyst: A case report and review of literature. World J Clin Cases 2024; 12:2586-2596. [DOI: 10.12998/wjcc.v12.i15.2586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 02/28/2024] [Accepted: 04/07/2024] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND Bronchogenic cysts are rare developmental anomalies that belong to the category of congenital enterogenous cysts. They arise from lung buds and are present at birth. The embryonic foregut is their origin. Typically, they are located within the chest cavity, particularly in the cavum mediastinale of the thoracic cavity or lodged in the pulmonary parenchyma, and are considered a type of lung bud malformation.
CASE SUMMARY A 49-year-old male patient was admitted to the hospital due to the detection of a retroperitoneal mass during a physical examination. Two weeks before admission, the patient underwent a physical examination and routine laboratory tests, which revealed a space-occupying mass in the retroperitoneal region. The patient did not report any symptoms (such as abdominal pain, flatulence, nausea, vomiting, high fever, or chills). The computed tomography (CT) revealed a retroperitoneal space-occupying lesion with minimal enhancement and a CT value of approximately 36 Hounsfield units. The lesion was not delineated from the boundary of the pancreatic body and was closely related to the retroperitoneum locally.
CONCLUSION Following a series of tests, an abdominal mass was identified, prompting the implementation of a laparoscopic retroperitoneal mass excision procedure. During the investigation, an 8 cm × 7 cm cystic round-shaped mass with a distinct demarcation was identified in the upper posterior region of the pancreas. Subsequently, full resection of the mass was performed. Postoperative pathological examination reveled a cystic mass characterized by a smooth inner wall. The cystic mass was found to contain a white, viscous liquid within its capsule.
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Affiliation(s)
- Abdul Malik
- Department of General Surgery, The Affiliated Hospital of Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
- Department of Preventive Medicine and Public Health Laboratory Science, School of Medicine, Jiangsu University, Zhenjiang 212013, Jiangsu Province, China
| | - Qais Ahmad Naseer
- Department of General Surgery, The Affiliated Hospital of Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
- Department of Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang 212013, Jiangsu Province, China
| | - Muhammad Asad Iqbal
- Department of General Surgery, The Affiliated Hospital of Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
| | - Shi-Ya Han
- Department of Clinical Pharmacy, Shenyang Pharmaceutical University, Shenyang 110000, Liaoning Province, China
| | - Sheng-Chun Dang
- Department of General Surgery, The Affiliated Hospital of Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
- Department of Surgery, Siyang Hospital, Suqian 223700, Jiangsu Province, China
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Lu XR, Jiao XG, Sun QH, Li BW, Zhu QS, Zhu GX, Qu JJ. Young patient with a giant gastric bronchogenic cyst: A case report and review of literature. World J Clin Cases 2024; 12:2254-2262. [DOI: 10.12998/wjcc.v12.i13.2254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 02/09/2024] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
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.
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Affiliation(s)
- Xu-Ren Lu
- School of Clinical Medicine, Shandong Second Medical University, Weifang 261000, Shandong Province, China
- Department of Gastrointestinal Surgery Medical Center, The First Affiliated Hospital, Shandong Second Medical University, Weifang 261000, Shandong Province, China
| | - Xu-Guang Jiao
- Department of Gastrointestinal Surgery Medical Center, The First Affiliated Hospital, Shandong Second Medical University, Weifang 261000, Shandong Province, China
| | - Qi-Hang Sun
- School of Clinical Medicine, Shandong Second Medical University, Weifang 261000, Shandong Province, China
- Department of Gastrointestinal Surgery Medical Center, The First Affiliated Hospital, Shandong Second Medical University, Weifang 261000, Shandong Province, China
| | - Bo-Wen Li
- School of Clinical Medicine, Shandong Second Medical University, Weifang 261000, Shandong Province, China
- Department of Gastrointestinal Surgery Medical Center, The First Affiliated Hospital, Shandong Second Medical University, Weifang 261000, Shandong Province, China
| | - Qing-Shun Zhu
- Department of Gastrointestinal Surgery Medical Center, The First Affiliated Hospital, Shandong Second Medical University, Weifang 261000, Shandong Province, China
| | - Guang-Xu Zhu
- Department of Gastrointestinal Surgery Medical Center, The First Affiliated Hospital, Shandong Second Medical University, Weifang 261000, Shandong Province, China
| | - Jian-Jun Qu
- Department of Gastrointestinal Surgery Medical Center, The First Affiliated Hospital, Shandong Second Medical University, Weifang 261000, Shandong Province, China
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Dohna M, Hirsch WF, Dingemann J, Gräfe D. [Congenital pulmonary malformations : Diagnosis and treatment]. Radiologie (Heidelb) 2024; 64:357-365. [PMID: 38546875 DOI: 10.1007/s00117-024-01291-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/06/2024] [Indexed: 05/02/2024]
Abstract
PERFORMANCE Congenital pulmonary malformations (CPM) are rare and can be associated with high morbidity. Clinical presentation, diagnostic procedures, imaging, and therapy of CPM are discussed. ACHIEVEMENTS Today, most CPM can be diagnosed prenatally by ultrasound. Postnatally, respiratory symptoms up to respiratory failure and recurrent lower respiratory tract infection are typical findings. Due to low diagnostic accuracy of chest x‑ray in CPM, all children with prenatal diagnosis of CPM or postnatally suspected CPM should undergo cross-sectional imaging. PRACTICAL RECOMMENDATIONS Based on imaging alone, the various subtypes of CPM cannot be definitively differentiated, which is why histological confirmation remains the gold standard. Surgical resection is the standard of care with minimally invasive procedures increasingly being employed. In certain situations, a watch-and-wait approach is possible.
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Affiliation(s)
- M Dohna
- Institut für diagnostische und interventionelle Radiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
- Klinik für diagnostische und interventionelle Radiologie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.
| | - W F Hirsch
- Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - J Dingemann
- Institut für diagnostische und interventionelle Radiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
- Klinik für Kinderchirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - D Gräfe
- Universitätsklinikum Leipzig, Leipzig, Deutschland
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Hsieh CJ, Huang SY, Chou CM, Tseng JJ. Congenital bronchogenic cyst: From prenatal diagnosis to postnatal management. Taiwan J Obstet Gynecol 2024; 63:229-233. [PMID: 38485320 DOI: 10.1016/j.tjog.2024.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2023] [Indexed: 03/19/2024] Open
Abstract
OBJECTIVE Bronchogenic cysts are rare congenital abnormalities, and usually asymptomatic until adulthood. We present a fetus prenatally diagnosed with a bronchogenic cyst, experiencing compression symptoms immediately after birth and underwent thoracoscopic surgery at 14 days old. CASE REPORT A 33-year-old primigravida had a suspicion of fetal tracheal cyst. Prenatal ultrasound scan revealed a cyst near the trachea at 23 weeks' gestation. Fetal MRI defined a cystic lesion in the upper mediastinum, displacing surrounding vessels. A 3,940 g girl was delivered vaginally at 38 weeks' gestation. Shortly after birth, she developed respiratory distress, and imaging revealed a mediastinal cyst compressing the trachea and esophagus. The cyst was successfully removed through video-assisted thoracoscopic surgery at 14 days old, and pathology confirmed it as a bronchogenic cyst. Follow-up images demonstrated well-aerated lungs. At present, this 1-year-old girl develops normally without respiratory symptoms. CONCLUSION Early detection in utero, accurate diagnosis, and timely management are crucial for bronchogenic cysts in neonates.
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Affiliation(s)
- Chia-Jung Hsieh
- Imaging Center for Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Sheng-Yang Huang
- Division of Pediatric Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Chia-Man Chou
- Division of Pediatric Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Jenn-Jhy Tseng
- Imaging Center for Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
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Kumbasar U, Uysal S, Doğan R. Congenital pulmonary malformations. Turk Gogus Kalp Damar Cerrahisi Derg 2024; 32:S60-S72. [PMID: 38584784 PMCID: PMC10995677 DOI: 10.5606/tgkdc.dergisi.2024.25713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/11/2023] [Indexed: 04/09/2024]
Abstract
There are many congenital anomalies of the lung, some of which have no clinical symptoms and are detected incidentally, while others, particularly in the neonatal and infant period, are recognized by their typical signs, symptoms, and radiological appearance. Some congenital lung anomalies are so important that they can cause the death of the patient if not diagnosed and treated early. Classification of congenital lung anomalies is difficult since these anomalies may be related to the airway, arterial and venous vascular system, pulmonary parenchyma, and primitive anterior intestinal anomalies from which the lung originates, and some anomalies may have several etiologic origins. In this review, all subgroups of congenital pulmonary malformations will be discussed.
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Affiliation(s)
- Ulaş Kumbasar
- Department of Thoracic Surgery, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Serkan Uysal
- Department of Thoracic Surgery, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Rıza Doğan
- Department of Thoracic Surgery, Hacettepe University Faculty of Medicine, Ankara, Türkiye
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Madhusudan M, Chandra T, Potti P, Jingade ST. Role of esophageal ultrasound with a bronchoscope (EUS-B) with fine needle aspiration in the diagnosis of mediastinal Bronchogenic cyst. Pediatr Pulmonol 2023; 58:3612-3614. [PMID: 37701980 DOI: 10.1002/ppul.26675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 08/16/2023] [Accepted: 09/01/2023] [Indexed: 09/14/2023]
Abstract
A 12-year-old adolescent boy presented with complaints of persisting dry cough and exertional dyspnea. A CT chest revealed a cystic lesion posterior to the trachea and a flexible bronchoscopy revealed extrinsic compression of the posterior trachea and partial obstruction of the left main bronchus. He underwent an Endoscopic Ultrasound with a Bronchoscope. A Hypoechoic cystic lesion was seen just in front of the esophagus. Fine needle aspiration yielded thick mucoid aspirate and cytology revealed ciliated columnar epithelium, confirming the diagnosis of a Bronchogenic cyst.
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Affiliation(s)
- Manoj Madhusudan
- Department of Pediatric Pulmonology, Interventional Pulmonology and Sleep Medicine, Aster RV Hospital, Bengaluru, India
| | - Tejaswi Chandra
- Department of Pediatric Pulmonology, Interventional Pulmonology and Sleep Medicine, Aster RV Hospital, Bengaluru, India
| | - Priyanka Potti
- Department of Pediatric Pulmonology, Interventional Pulmonology and Sleep Medicine, Aster RV Hospital, Bengaluru, India
| | - Srikanta T Jingade
- Department of Pediatric Pulmonology, Interventional Pulmonology and Sleep Medicine, Aster RV Hospital, Bengaluru, India
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Rahman ST, Islam MM, Akhter KM, Islam MZ, Hossain M. Bronchogenic cyst at unusual location. Respir Med Case Rep 2023; 46:101947. [PMID: 38058403 PMCID: PMC10696229 DOI: 10.1016/j.rmcr.2023.101947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 11/03/2023] [Accepted: 11/08/2023] [Indexed: 12/08/2023] Open
Abstract
Bronchogenic cyst results from abnormal bronchial budding. Thin-stalked mobile bronchogenic cysts are rare and sometimes radiologically mimic mass lesion, making preoperative diagnosis difficult. We present a 12-year-old boy with a preoperative diagnosis of intraparenchymal cystic lung lesion misled by radiology. We performed a mini-thoracotomy revealing a thin stalked mobile elongated cyst that arose from the right inferior pulmonary ligament, confirmed as a bronchogenic cyst in histopathology.
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Affiliation(s)
- S.M. Tajdit Rahman
- Department of Thoracic Surgery, National Institute of Diseases of the Chest & Hospital, Dhaka, Bangladesh
| | - Md. Morsedul Islam
- Department of Thoracic Surgery, National Institute of Diseases of the Chest & Hospital, Dhaka, Bangladesh
| | - Kazi Munzerin Akhter
- Department of Thoracic Surgery, National Institute of Diseases of the Chest & Hospital, Dhaka, Bangladesh
| | - Md. Zahidul Islam
- Department of Thoracic Surgery, National Institute of Diseases of the Chest & Hospital, Dhaka, Bangladesh
| | - Mosharraf Hossain
- Department of Thoracic Surgery, National Institute of Diseases of the Chest & Hospital, Dhaka, Bangladesh
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He C, Yu HX, Liu ZJ, Yin C. Case report: Two rare new cases of diaphragmatic bronchogenic cysts. Heliyon 2023; 9:e21545. [PMID: 38027976 PMCID: PMC10643278 DOI: 10.1016/j.heliyon.2023.e21545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 10/17/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
The bronchogenic cyst (BC) is a type of congenital anomaly that is most usually found in the mediastinum and lung, and rarely in the diaphragm. We report two cases of bronchogenic cysts originating from the left diaphragm. Case 1 involved a 50-year-old man who underwent computed tomography (CT) of the adrenal glands for hypertension, showing left adrenal changes. An adrenal CT at our hospital showed a space-occupying lesion above the left diaphragm. We performed a left-sided thoracotomy in the seventh intercostal space and found that the mass was entirely located in the diaphragm. Case 2 was a 58-year-old woman who underwent chest CT under a standard health check-up, and a subpleural lesion of approximately 4 cm was found in the posterior basal segment of the left inferior lung lobe. During thoracoscopic surgery, the mass was found to originate from the surface of the diaphragm, having no correlation with the lung tissue. The two cases of diaphragmatic bronchogenic cysts were confirmed by surgical pathology. Ectopic bronchogenic cysts arising from the diaphragm are very uncommon, and diaphragmatic bronchogenic cysts typically occur on the left side, in women, and in the angle between the vertebral column and the diaphragm. As far as we know, there are no relevant reports of intradiaphragmatic BCs similar to case 1, which was entirely located within the diaphragm. Most diaphragmatic BCs are located on the surface of the diaphragm and project toward the thoracic or abdominal cavities. Moreover, bilocular diaphragmatic bronchogenic cysts, similar to case 2, have not yet been reported.
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Affiliation(s)
- Chao He
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Hai-Xiang Yu
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Zheng-Jia Liu
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Cong Yin
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
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陈 伟, 徐 梦, 王 庆, 陈 佳, 孙 广, 李 晓. [Diagnosis and treatment of pediatric cervical bronchogenic cyst]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 37:916-919. [PMID: 37905487 PMCID: PMC10985664 DOI: 10.13201/j.issn.2096-7993.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Indexed: 11/02/2023]
Abstract
Objective:To investigate the clinical characteristics and surgical treatment outcomes of children with cervical bronchogenic cysts. Methods:A retrospective study of 6 pediatric patients with bronchogenic cysts in the neck region treated in our hospital during 2014 to 2020 was performed. All children underwent complete resection of cervical mass under general anesthesia. Results:There were 6 children, aged from 1 to 5 years, with a median of 2.25 years. There were 3 males and 3 females. The lesions were located on the left neck in 3 cases, the midline neck in 2 cases and the right neck in 1 case. The clinical manifestations were painless mass in 5 cases and recurrent neck infection in 1 case. The size of the mass ranged from 2.1 to 7.5 cm. There was no characteristic clinical or imaging features of bronchogenic cysts. Misdiagnosed as lymphangioma in 3 cases, thyroglossal cyst in 2 cases and piriform fistula in 1 case. The follow-up ranged from 1.50 to 7.75 years, with a median of 4.13 years. All 6 children had no recurrence or complications. Conclusion:Although rare, bronchogenic cysts should be considered in the differential diagnosis of cervical cystic masses in children. Surgery is the most effective way to treat cervical bronchogenic cyst, and histopathological examination is the gold standard for diagnosis.
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Affiliation(s)
- 伟 陈
- 上海市儿童医院 上海交通大学医学院附属儿童医院耳鼻咽喉头颈外科(上海,200062)Department of Otolaryngology-Head and Neck Surgery, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200062, China
- 复旦大学附属华山医院耳鼻咽喉头颈外科Department of Otolaryngology Head and Neck Surgery, Huashan Hospital Affiliated to Fudan University
| | - 梦柔 徐
- 上海市儿童医院 上海交通大学医学院附属儿童医院耳鼻咽喉头颈外科(上海,200062)Department of Otolaryngology-Head and Neck Surgery, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200062, China
| | - 庆煜 王
- 上海市儿童医院 上海交通大学医学院附属儿童医院病理科Department of Pathology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University
| | - 佳瑞 陈
- 上海市儿童医院 上海交通大学医学院附属儿童医院耳鼻咽喉头颈外科(上海,200062)Department of Otolaryngology-Head and Neck Surgery, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200062, China
| | - 广滨 孙
- 复旦大学附属华山医院耳鼻咽喉头颈外科Department of Otolaryngology Head and Neck Surgery, Huashan Hospital Affiliated to Fudan University
| | - 晓艳 李
- 上海市儿童医院 上海交通大学医学院附属儿童医院耳鼻咽喉头颈外科(上海,200062)Department of Otolaryngology-Head and Neck Surgery, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200062, China
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Maidman SD, Bamira D, Vainrib AF, Ro R, Saric M. Cysts Around the Heart: Differential Diagnosis and Multimodality Imaging Strategies for Paracardiac Cysts. CASE (Phila) 2023; 7:365-376. [PMID: 37791128 PMCID: PMC10543172 DOI: 10.1016/j.case.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
•Paracardiac cysts (located adjacent to or inside the heart) are rarely detected. •There is a broad differential diagnosis for cysts encountered with echocardiography. •Multimodality imaging is crucial for comprehensively evaluating paracardiac cysts.
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Affiliation(s)
- Samuel D. Maidman
- Leon H. Charney Division of Cardiology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
| | - Daniel Bamira
- Leon H. Charney Division of Cardiology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
| | - Alan F. Vainrib
- Leon H. Charney Division of Cardiology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
| | - Richard Ro
- Leon H. Charney Division of Cardiology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
| | - Muhamed Saric
- Leon H. Charney Division of Cardiology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
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Phan AT, Hu J, Oganesian B, Williams SO. Symptomatic Bronchogenic Cyst in a Lipomatous Interatrial Septum. Cardiol Res 2023; 14:315-318. [PMID: 37559710 PMCID: PMC10409548 DOI: 10.14740/cr1511] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 06/01/2023] [Indexed: 08/11/2023] Open
Abstract
Intracardiac bronchogenic cysts are extremely rare congenital anomalies that arise during foregut development when the embryologic heart tube and ventral foregut are in close proximity to one another. We report a case of an interatrial septal bronchogenic cyst found on non-contrast enhanced computed tomography (CT) in a 66-year-old female who presented to the emergency department with chest pain. Further cardiac investigations, including contrast-enhanced CT angiogram of the heart, transthoracic echocardiogram, and transesophageal echocardiogram, revealed a cystic mass in the lipomatous interatrial septum. The patient was subsequently diagnosed with a bronchogenic cyst of the interatrial septum. No surgical intervention was pursued, as the mass remained stable, and the cardiothoracic surgeon did not recommend excision. This case highlights a rare case of a symptomatic bronchogenic cyst arising in the interatrial septum diagnosed by imaging modalities. Bronchogenic cysts should be included in the differential diagnosis of intracardiac tumors.
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Affiliation(s)
- Alexander T. Phan
- Department of Internal Medicine, Arrowhead Regional Medical Center, Colton, CA 92324, USA
| | - Janie Hu
- Department of Internal Medicine, Arrowhead Regional Medical Center, Colton, CA 92324, USA
| | - Buzand Oganesian
- Department of Internal Medicine, Arrowhead Regional Medical Center, Colton, CA 92324, USA
| | - Shammah O. Williams
- Department of Cardiology, Arrowhead Regional Medical Center, Colton, CA 92324, USA
- Department of Cardiology, Loma Linda University, Loma Linda, CA 92305, USA
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Joalsen I, Caesario M, Sahniar N, Boenjamin AA. Uniportal vats approach to bronchogenic cyst, East Borneo experience: A case report. Int J Surg Case Rep 2023; 109:108527. [PMID: 37541013 PMCID: PMC10407889 DOI: 10.1016/j.ijscr.2023.108527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/11/2023] [Accepted: 07/15/2023] [Indexed: 08/06/2023] Open
Abstract
INTRODUCTION Abnormalities in the development of the ventral foregut may result in bronchogenic cysts. Depending on the extent of aberrant budding, the location of a bronchogenic cyst might vary. The location and, more crucially, the size of the mass determine the onset of symptoms in individuals with bronchogenic cysts. Mediastinal bronchogenic cysts are mostly asymptomatic mediastinal masses discovered incidentally in adults. With the recent advancements in thoracoscopy, the removal can now be performed without the need for thoracotomies. CASE PRESENTATION We reported the case of incidental findings of an asymptomatic mediastinal bronchogenic cyst and opted for single-incision video-assisted thoracic surgery. The patient required no postoperative intensive care and discharged on third day after surgery with no complications. DISCUSSION Single-incision video-assisted thoracic surgery, also known as uniportal VATS, has swept the field of thoracic surgery in recent years, allowing us to execute challenging surgeries with a small single incision, avoiding the inherent morbidity of the standard open thoracotomy. We were able to remove mediastinal bronchogenic cysts using uniportal VATS completely. This method eliminates the need for post-operative critical care, reducing scarring and shortening hospital stays. CONCLUSION Bronchogenic cysts are uncommon mediastinal masses necessary for surgical therapy when discovered. The advancement of minimally invasive techniques offers surgeons safe new alternatives.
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Affiliation(s)
- Ivan Joalsen
- Division of Thoracic, Cardiac, and Vascular Surgery, Universitas Mulawarman/Abdul Wahab Sjahranie Hospital, Samarinda, East Borneo, Indonesia.
| | - Michael Caesario
- Division of Thoracic, Cardiac, and Vascular Surgery, Universitas Mulawarman/Abdul Wahab Sjahranie Hospital, Samarinda, East Borneo, Indonesia
| | - Novita Sahniar
- Intern Doctor of Thoracic, Cardiac, and Vascular Surgery, Abdul Wahab Sjahranie Hospital, Samarinda, East Borneo, Indonesia
| | - Abdul Azis Boenjamin
- General Surgery Resident Universitas Mulawarman/Abdul Wahab Sjahranie Hospital, Samarinda, East Borneo, Indonesia
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13
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Bouassida I, Hadj Dahmane M, Zribi H, Bessrour H, Hachicha S, Marghli A. A poor prognosis of a mediastinal bronchogenic cyst with malignant transformation: A case report. Int J Surg Case Rep 2023; 106:108246. [PMID: 37146554 DOI: 10.1016/j.ijscr.2023.108246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 04/14/2023] [Accepted: 04/19/2023] [Indexed: 05/07/2023] Open
Abstract
INTRODUCTION Bronchogenic cysts (BC) are congenital lesions, it results from an abnormal budding of the tracheobronchial tree. Malignant transformation is very rare. We report a case of adenocarcinoma arising in a BC of the posterior mediastinum detected after surgery. PRESENTATION OF CASE We report the case of a 32-year-old man, without a particular medical history. The patient presented a cough associated with dyspnea, and a weight loss 4-month before the diagnosis. The imaging tools, showed a voluminous latero-tracheal mass of the posterior mediastinum. The diagnoses of a neurogenic tumor or a BC were suspected. The patient was treated by video-assisted thoracoscopy. Complete excision was done complicated by lesion's small rupture. The microscopic exam revealed unfortunately an adenocarcinoma arising in a BC. The patient had started the cure of chemotherapy. Six months later, the patient died due to tumor recurrence with cerebral metastasis. DISCUSSION Mediastinum BC, is usually located within the middle and posterior mediastinum. This condition is a benign congenital lesion. His curative therapy was a complete surgical resection with a good prognosis. However, malignant transformation may seldom occur and is most often accidentally diagnosed during the histological examination of specimens. In this case, the surgical treatment may be insufficient, and the prognosis may be poor. CONCLUSION Malignant degeneration of mediastinal BC, despite being rare, should be kept in mind, carefully avoided and managed.
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Affiliation(s)
- Imen Bouassida
- Department of Thoracic Surgery, Abderrahmen Mami Hospital of Ariana, Tunisia
| | - Mariem Hadj Dahmane
- Department of Thoracic Surgery, Abderrahmen Mami Hospital of Ariana, Tunisia.
| | - Hazem Zribi
- Department of Thoracic Surgery, Abderrahmen Mami Hospital of Ariana, Tunisia
| | - Habib Bessrour
- Department of Cardiothoracic Surgery, The Principal Military Hospital of Instruction of Tunis, Tunisia
| | - Saber Hachicha
- Department of Cardiothoracic Surgery, The Principal Military Hospital of Instruction of Tunis, Tunisia
| | - Adel Marghli
- Department of Thoracic Surgery, Abderrahmen Mami Hospital of Ariana, Tunisia
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Abstract
Background and Objective Bronchogenic cysts represent a rare form of cystic malformation of the respiratory tract. Primarily located in the mediastinum if occurring early in gestation as opposed to the thoracic cavity if arising later in development. However, they can arise from any site along the foregut. They exhibit a variety of clinical and radiologic presentations, representing a diagnostic challenge, especially in areas with endemic hydatid disease. Endoscopic drainage has emerged as a diagnostic and potentially therapeutic option but has been complicated by reports of infection. Surgical excision remains the standard of care allowing for symptomatic resolution and definitive diagnosis via pathologic examination; minimally invasive approaches such as robotic and thoracoscopic approaches aiding treatment. Following complete resection, prognosis is excellent with essentially no recurrence. Methods A review of the available electronic literature was performed from 1975 through 2022, using PubMed and Google Scholar, with an emphasis on more recent series. We included all retrospective series and case reports. A single author identified the studies, and all authors reviewed the selection until there was a consensus on which studies to include. Key Content and Findings The literature consisted of relatively small series, mixed between adult and pediatric patients, and the consensus remains that all symptomatic lesions should be excised via minimally invasive approach where feasible. Conclusions Surgical excision of symptomatic bronchogenic cysts remains the gold standard, with endoscopic drainage being reserved for diagnosis or as a temporizing measure in clinically unstable patients.
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Affiliation(s)
- Daniel J. Gross
- Thoracic Surgery Section, Division of Cardiothoracic Surgery, The DeWitt Daughtry Family Department of Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
| | | | - Eric M. Wherley
- Thoracic Surgery Section, Division of Cardiothoracic Surgery, The DeWitt Daughtry Family Department of Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Dao M. Nguyen
- Thoracic Surgery Section, Division of Cardiothoracic Surgery, The DeWitt Daughtry Family Department of Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
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15
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Yang B, Liu L, Tian X, Hou X, Lu M, Ma L. Retroperitoneal bronchogenic cyst resembling an adrenal tumor in adult: Three case reports and literature review. Ann Med Surg (Lond) 2023; 85:473-6. [PMID: 36923759 DOI: 10.1097/MS9.0000000000000182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 12/24/2022] [Indexed: 03/18/2023] Open
Abstract
Bronchogenic cyst is a rare congenital malformation of the tracheobronchial bud originating from the primitive foregut, especially in the retroperitoneal region. Retroperitoneal bronchogenic cysts in adults are difficult to make an accurate diagnosis preoperatively. Case presentation We present three cases of retroperitoneal bronchogenic cysts resembling adrenal tumors in adults. Three cases were asymptomatic, and all were located on the left side. There was no significant enhancement of the cyst walls on contrast-enhanced computed tomography. Two cases presented with typical multilocular sacs and scattered calcification on radiology, whereas the other one showed unilocular sacs, without calcification, and elevation of serum carbohydrate antigen (CA) 19-9 and CA 24-2. Three cases underwent retroperitoneal laparoscopic surgeries. Histopathologic examination confirmed the diagnosis of retroperitoneal bronchogenic cysts. There was no recurrence of the three cases during follow-up. Clinical Discussion A retroperitoneal bronchogenic cyst is mostly asymptomatic. It can be found in adults with variable findings in computed tomography. It can be likely ignored and misdiagnosed as an adrenal tumor. Conclusion The tests of CA 19-9 and CA 24-2 could help diagnose retroperitoneal bronchogenic cysts. Retroperitoneal laparoscopic surgery is recommended for the treatment of retroperitoneal bronchogenic cysts with a favorable prognosis.
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16
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Singh A, Mandelia A, Kawdiya A, Naranje K, Nigam N. Evolution of Antenatally Diagnosed Bronchogenic Cyst in an Infant. J Indian Assoc Pediatr Surg 2023; 28:66-68. [PMID: 36910298 PMCID: PMC9997589 DOI: 10.4103/jiaps.jiaps_87_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/01/2022] [Accepted: 07/30/2022] [Indexed: 03/14/2023] Open
Abstract
Bronchogenic cyst is one of the rare developmental lung conditions. Depending on the location, it can cause significant compression of the mediastinal structures, especially airways leading to atelectasis, emphysema, wheezing, and stridor. Computerized tomography helps in the confirmation of diagnosis. Surgery is definitive management. We present a case of bronchogenic cyst which presented as emphysema leading to respiratory emergency in an infant.
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Affiliation(s)
- Anita Singh
- Department of Neonatology, Pediatric Surgery and Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Ankur Mandelia
- Department of Neonatology, Pediatric Surgery and Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Apurva Kawdiya
- Department of Pediatrics, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Kirti Naranje
- Department of Neonatology, Pediatric Surgery and Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Neha Nigam
- Department of Neonatology, Pediatric Surgery and Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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17
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Nuñez-Paucar H, Atamari-Anahui N, Valera-Moreno C. Congenital pulmonary malformations in children in a pediatric hospital in Peru, 2010-2020. Bol Med Hosp Infant Mex 2023; 80:235-241. [PMID: 37703573 DOI: 10.24875/bmhim.23000055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 07/20/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Congenital pulmonary malformations (CPMs) are rare in children. This study aimed to describe the clinical, imaging characteristics, and treatment of patients with this pathology. METHODS We conducted a descriptive and retrospective study with data from patients with CPMs diagnosed at Instituto Nacional de Salud del Niño-Breña (Lima-Peru), from January 2010 to December 2020. We described CPM clinical and imaging characteristics, type and treatment. RESULTS The sample was formed of 70 patients. The median age was 29 months (range 15 days-14 years) and the male/female ratio was 1.4. The chest tomography found parenchymal involvement in 50 (71.4%) cases and mixed involvement (parenchymal and vascular) in 18 (25.7%) cases. Congenital malformation of the pulmonary airway was present in 39 (55.7%) cases, followed by bronchogenic cyst in 10 (14.3%), intralobar pulmonary sequestration in 9 (12.9%), and extralobar pulmonary sequestration in 7 (10%). Lobectomy was performed in 61 (87.1%) cases, cystectomy in 5 (7.1%), segmentectomy in 2 (2.9%), and embolization in 2 (2.9%). The most frequent post-operative complication was pneumonia, found in 9 (12.9%) cases. The median hospital stay was 26 days. No patient died during hospitalization. CONCLUSIONS In our institution, the most frequent CPM was congenital malformation of the pulmonary airway, and lobectomy was the most frequently performed surgical procedure. CPMs represent a diverse group of disorders of lung development with varied imaging patterns and clinical manifestations.
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Affiliation(s)
- Héctor Nuñez-Paucar
- Instituto Nacional de Salud del Niño-Breña
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola. Lima, Peru
| | - Noé Atamari-Anahui
- Instituto Nacional de Salud del Niño-Breña
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola. Lima, Peru
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18
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Li C, Zhang XW, Zhao CA, Liu M. Abdominal bronchogenic cyst: A rare case report. World J Clin Cases 2022; 10:12671-12677. [PMID: 36579087 PMCID: PMC9791524 DOI: 10.12998/wjcc.v10.i34.12671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/29/2022] [Accepted: 10/12/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Bronchogenic cysts are cystic masses caused by congenital abnormal development of the respiratory system, and usually occur in the pulmonary parenchyma or mediastinum.
CASE SUMMARY A rare case of a bronchogenic cyst discovered in the abdominal cavity of a 35-year-old man is reported. Physical examination found a space-occupying lesion in the patient’s abdomen for 4 d. Laparoscopic exploration found the cyst tightly adhered to the stomach and its peripheral blood vessels; therefore, intraoperative laparotomy was performed. The cystic mass was resected en bloc with an Endo-GIA stapler. The final postoperative pathological diagnosis confirmed an abdominal bronchogenic cyst.
CONCLUSION This is a rare case of a bronchogenic cyst that was discovered within the abdominal cavity of a male patient. The cyst is easily confused with or misdiagnosed as other lesions. Therefore, it is necessary to distinguish abdominal bronchogenic cyst from gastrointestinal stromal tumor, Meckel’s diverticulum, enteric duplication cyst, or lymphangioma. Although computer tomography and magnetic resonance imaging were the primary diagnostic approaches, endoscopic ultrasound-guided fine-needle aspiration could assist with clarification of the cytological or histopathological diagnosis before surgery.
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Affiliation(s)
- Chao Li
- School of Public Health, Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
- Department of General Surgery, Xi’an Gaoxin Hospital, Xi'an 710075, Shaanxi Province, China
| | - Xin-Wei Zhang
- Department of Thoracic Surgery, Shaanxi Provincial Cancer Hospital, Xi’an 710061, Shaanxi Province, China
| | - Chang-An Zhao
- Department of Pathology, School of Basic Medical Science, Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
| | - Min Liu
- Department of General Surgery, Xi’an Gaoxin Hospital, Xi'an 710075, Shaanxi Province, China
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19
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Abstract
Congenital lung malformations represent a spectrum of lesions, each with a distinct cause and tailored clinical approach. This article will focus on the following malformations: congenital pulmonary airway malformations, formally known as congenital cystic adenomatoid malformations, bronchopulmonary sequestration, congenital lobar emphysema, and bronchogenic cyst. Each of these malformations will be defined and examined from an embryologic, pathophysiologic, and clinical management perspective unique to that specific lesion. A review of current recommendations in both medical and surgical management of these lesions will be discussed as well as widely accepted treatment algorithms.
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Affiliation(s)
- Brittany N Hegde
- Department of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 5.256, Houston, TX 77030, USA; Center for Surgical Trials and Evidence-Based Practice (C-STEP), McGovern Medical School at the University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 5.256, Houston, TX 77030, USA
| | - KuoJen Tsao
- Department of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 5.256, Houston, TX 77030, USA; Center for Surgical Trials and Evidence-Based Practice (C-STEP), McGovern Medical School at the University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 5.256, Houston, TX 77030, USA
| | - Shinjiro Hirose
- Division of Pediatric, Thoracic, and Fetal Surgery, University of California-Davis Medical Center, 2335 Stockton Boulevard, Sacramento, CA 95817, USA.
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20
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Jiao J, Fan X, Luo L, Zheng Z, Wang B, Liu W. Endoscopic resection in the treatment of intramural esophageal bronchogenic cysts: A retrospective analysis of 17 cases. Dig Liver Dis 2022; 54:1691-1697. [PMID: 36096990 DOI: 10.1016/j.dld.2022.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/07/2022] [Accepted: 08/19/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Intramural esophageal bronchogenic cysts (EBCs) are rare congenital malformations. Differences in reports on the clinical features of intramural EBCs and some controversies about the treatment strategy for intramural EBCs exist. OBJECTIVES To investigate the clinical characteristics of intramural EBCs and evaluate the safety and efficacy of endoscopic resection. METHODS The clinical and endoscopic features, endoscopic resection treatment, postoperative adverse events, and follow-up results of 17 patients with intramural EBCs were retrospectively studied. RESULTS Intramural EBCs exhibited male predominance with a male/female ratio of 58.8% (10/7) and were predominantly found in the distal esophagus. Approximately 94.1% of patients presented with gastrointestinal symptoms. All lesions were protruding masses covered by intact mucosal epithelium. The morphologies of intramural EBCs were diverse under white light endoscopy. On endoscopic ultrasonography, intramural EBCs presented as homogeneous or inhomogeneous hypoechoic or anechoic lesions. Eleven lesions originated from the muscularis propria, which underwent submucosal tunnel endoscopic resection (STER), and six lesions were from the submucosa, which underwent endoscopic submucosal dissection (ESD). Approximately 88.2% of patients underwent complete endoscopic resection. No serious pneumothorax, bleeding, pleural effusion, esophagotracheal fistula, or other adverse events occurred in all patients after endoscopic resection, and no cyst recurrence, metastasis, or esophageal scar stenosis was observed during the follow-up period. CONCLUSIONS Intramural EBCs can be treated by digestive endoscopic surgery. STER and ESD are safe, effective, and minimally invasive resection methods.
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Affiliation(s)
- Jiao Jiao
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin, China; Institute of Digestive Diseases, Tianjin Key Laboratory of Digestive Diseases, Tianjin, China
| | - Xiaofei Fan
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin, China; Institute of Digestive Diseases, Tianjin Key Laboratory of Digestive Diseases, Tianjin, China
| | - Lili Luo
- Department of geriatric, General Hospital, Tianjin Medical University, Tianjin, China
| | - Zhongqing Zheng
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin, China; Institute of Digestive Diseases, Tianjin Key Laboratory of Digestive Diseases, Tianjin, China
| | - Bangmao Wang
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin, China; Institute of Digestive Diseases, Tianjin Key Laboratory of Digestive Diseases, Tianjin, China
| | - Wentian Liu
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin, China; Institute of Digestive Diseases, Tianjin Key Laboratory of Digestive Diseases, Tianjin, China.
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21
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Nzomvuama Ndonga N'sungu A, Sakaji Manyka TJ, Noutakdie Tochie J. Mediastinal bronchogenic cyst resected in Kinshasa, Democratic Republic of Congo. A case report. Int J Surg Case Rep 2022; 101:107775. [PMID: 36455346 PMCID: PMC9706695 DOI: 10.1016/j.ijscr.2022.107775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/02/2022] [Accepted: 11/07/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Bronchogenic cyst (BC) is an uncommon, benign congenital mediastinal tumor. Its progressive course is often asymptomatic, making the diagnosis difficult or fortuitous, unless non-specific respiratory signs appear, such as persistent cough or respiratory discomfort. We herein report the first documented case in the Democratic Republic of Congo (DRC). PRESENTATION OF CASE A 63-year-old man, with no prior medical or surgical history, consulted for a persistent dry cough, unresponsive to usual medical treatment. A chest CT scan revealed a cystic mediastinal mass close to both esophagus and aorta. This mass was completely resected through a left posterior thoracotomy. Histological examination confirmed the diagnosis of bronchogenic cyst. The postoperative course was uneventful. The cough was completely resolved. DISCUSSION BC is the most common cystic mass of the mediastinum. The case of BC that we report is the first documented and published in the DRC. Diagnosis is often fortuitous, unless clinical signs appear, usually cough, dyspnea, and in some cases fever, recurrent respiratory infections. The surgical resection of the BC must be complete to avoid recurrence, to prevent and treat possible complications. Surgery removes any diagnostic doubt by allowing histological examination of the cystic mass. CONCLUSION We reported our first resection of a BC. The preoperative diagnosis is often incidental. Complete resection of any BC allows histological diagnosis, treatment or prevention of complications.
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Affiliation(s)
- Alphonse Nzomvuama Ndonga N'sungu
- Department of Thoracic and Cardiovascular Surgery, Kinshasa University Hospital, Faculty of Medecine, Democratic Republic of the Congo,Corresponding author at: Department of Thoracic and Cardiovascular Surgery, Kinshasa University Hospital, Faculty of Medicine, BP 834, Democratic Republic of the Congo.
| | | | - Joël Noutakdie Tochie
- Department of Emergency, Anesthesiology and Critical Care Medecine, Laquintinie Hospital, Douala, Cameroon
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22
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Flórez Rial MDP, Ruz Portero S, Valenzuela González M, Romero Madrid B. [Intrapancreatic bronchogenic cyst. A case report]. Rev Esp Patol 2022; 55:292-296. [PMID: 36154740 DOI: 10.1016/j.patol.2020.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 11/20/2020] [Indexed: 06/16/2023]
Abstract
Bronchogenic cysts arise from abnormalities of the tracheobronchial tree occurring during the early stages of embryonal development. They are most often found in the posterior mediastinum. Retroperitoneal bronchogenic cysts are infrequent and intrapancreatic bronchogenic cysts extremely rare. We present a case of an asymptomatic, intrapancreatic bronchogenic cyst which was an incidental finding during the urological workup of a 61-year-old man.
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Affiliation(s)
| | - Sara Ruz Portero
- Servicio de Anatomía Patológica, Hospital Regional Universitario de Málaga, Málaga, España
| | | | - Beatriz Romero Madrid
- Servicio de Anatomía Patológica, Hospital Regional Universitario de Málaga, Málaga, España
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23
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Ma B, Fu KW, Xie XD, Cheng Y, Wang SQ. Bronchogenic cysts with infection in the chest wall skin of a 64-year-old asymptomatic patient: A case report. World J Clin Cases 2022; 10:8392-8399. [PMID: 36159540 PMCID: PMC9403674 DOI: 10.12998/wjcc.v10.i23.8392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/13/2022] [Accepted: 07/06/2022] [Indexed: 02/06/2023] Open
Abstract
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.
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Affiliation(s)
- Ben Ma
- Department of General, Chongqing University Cancer Hospital, Chongqing 400030, China
| | - Kai-Wen Fu
- Department of General, Chongqing University Cancer Hospital, Chongqing 400030, China
| | - Xu-Dong Xie
- Department of General, Chongqing University Cancer Hospital, Chongqing 400030, China
| | - Yue Cheng
- Department of General, Chongqing University Cancer Hospital, Chongqing 400030, China
| | - Sheng-Qiang Wang
- Department of General, Chongqing University Cancer Hospital, Chongqing 400030, China
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24
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Zheng CY, Su SY, Huang RB. Giant subcutaneous bronchogenic cyst in the intergluteal cleft region of an adult: a case report and literature review. BMC Med Imaging 2022; 22:126. [PMID: 35842586 PMCID: PMC9287924 DOI: 10.1186/s12880-022-00853-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 07/08/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Bronchogenic cysts (BCs) are generally detected in the mediastinum, along the tracheobronchial tree, or in the lung parenchyma. Subcutaneous BCs are rare, but, when found, are usually small (< 3 cm) and detected in children. CASE PRESENTATION In an unusual adult case, we treated a 52-year-old woman who presented with a mass in the left intergluteal cleft region. Ultrasonography showed a well-circumscribed hypoechoic lesion with posterior enhancement and internal echogenic foci within the mass. Color Doppler images showed no signals. Computed tomography showed the mass as a homogeneous, 6.8- × 6.3- × 5.1-cm soft tissue-attenuation lesion lodged in subcutaneous fatty tissue. Magnetic resonance imaging revealed a cystic lesion of similar dimensions with heterogeneous hyperintensity on both T1- and T2-weighted images. No contrast enhancement, solid components, or restricted diffusion foci were apparent. The cyst was completely excised, and histopathological evaluation indicated it was a BC. The patient's recovery was uneventful. CONCLUSIONS BCs should be considered in the differential diagnosis of all subcutaneous cystic masses, regardless of their location and size and the patient's age.
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Affiliation(s)
- Chuang-Yi Zheng
- Department of Orthopedics, First Affiliated Hospital, Shantou University Medical College, Shantou, Guangdong, People's Republic of China
| | - Shu-Yan Su
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
| | - Rui-Bin Huang
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, 515041, Guangdong, People's Republic of China
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25
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Gong YY, Qian X, Liang B, Jiang MD, Liu J, Tao X, Luo J, Liu HJ, Feng YG. Retroperitoneal tumor finally diagnosed as a bronchogenic cyst: A case report and review of literature. World J Clin Cases 2022; 10:6679-6687. [PMID: 35979308 PMCID: PMC9294898 DOI: 10.12998/wjcc.v10.i19.6679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/10/2022] [Accepted: 05/08/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Retroperitoneal bronchogenic cyst (RBC) is an extremely rare developmental abnormality. Most are benign tumors but malignant transformation is possible. Because of their anatomical position, RBCs are easily misdiagnosed as adrenal or pancreatic solid tumors on radiological evaluation. Here, we report a case of RBC, review the literature, and summarize some important features.
CASE SUMMARY A 49-year-old woman was incidentally found to have a retroperitoneal tumor during a physical examination. Enhanced computed tomography and laboratory evaluations, including routine blood examination, blood biochemistry, 24-h urine 17 ketones, 17 hydroxyls, adrenocortical hormone, serum potassium concentration, serum amylase, lipase, and epithelial tumor markers, revealed a moderate density, 54 mm × 40 mm mass with a clear boundary near the left adrenal gland. The were no abnormalities in the blood and urine values. Because the patient had a history of hypertension and the location of the mass was adjacent to the adrenal gland, it was initially diagnosed as a left adrenal tumor and was resected by retroperitoneal laparoscopy. However, the pathological examination after surgery confirmed it to be a bronchogenic cyst.
CONCLUSION Retroperitoneal laparoscopic surgery can be prioritized for symptomatic RBC patients. Conservative treatment is feasible for selected patients.
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Affiliation(s)
- Yang-Yang Gong
- Faculty of Medicine, Zunyi Medical University, Zunyi 563000, Guizhou Province, China
- Department of Urology, Suining Central Hospital, Suining 629000, Sichuan Province, China
| | - Xin Qian
- Faculty of Medicine, Zunyi Medical University, Zunyi 563000, Guizhou Province, China
- Department of Urology, Suining Central Hospital, Suining 629000, Sichuan Province, China
| | - Bo Liang
- Department of Urology, Suining Central Hospital, Suining 629000, Sichuan Province, China
| | - Ming-Dong Jiang
- Department of Urology, Suining Central Hospital, Suining 629000, Sichuan Province, China
| | - Jun Liu
- Department of Urology, Suining Central Hospital, Suining 629000, Sichuan Province, China
| | - Xing Tao
- Faculty of Medicine, Zunyi Medical University, Zunyi 563000, Guizhou Province, China
| | - Jing Luo
- Department of Urology, Suining Central Hospital, Suining 629000, Sichuan Province, China
| | - Hong-Jian Liu
- Department of Urology, Suining Central Hospital, Suining 629000, Sichuan Province, China
| | - You-Gang Feng
- Faculty of Medicine, Zunyi Medical University, Zunyi 563000, Guizhou Province, China
- Department of Urology, Suining Central Hospital, Suining 629000, Sichuan Province, China
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Singer C, Coşoveanu S, Petrescu I, Spătaru R, Ciobanu O, Dumitra G, Singer M, Neagoe D, Popescu M. Bronchogenic Cyst in Infants-Clinical and Histopathological Features. Curr Health Sci J 2022; 48:135-40. [PMID: 35911936 DOI: 10.12865/CHSJ.48.01.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 12/12/2021] [Indexed: 11/23/2022]
Abstract
A male infant, one month old, weight 4000 g, breastfed only, no pathological history, was admitted to the 2nd Pediatric Clinic, Clinical Emergency County Hospital in Craiova with fever and cough. Clinical findings when he was admitted: fever 38.7°C, perioral cyanosis, spastic cough, expiratory dyspnea, intercostal retraction, polypnea, subcrepitant rales in the right lung area. The chest x-ray revealed pneumonia aspect in the right middle perihilar region. He was administered antibiotic treatment, HHC, antithermics, with a favorable evolution. The control x-ray, when the infant was in a fair general state, with no disease symptomatology, pointed out a cystic formation at the level of the right middle lobe. The pulmonary CT revealed cavitary lesion, with a diameter of about 40mm in the right lung, and with the presence of septa to the interior and air content. The infant was urgently transferred to Marie Curie Hospital in Bucharest, where the cyst formation was removed through a surgical procedure. The anatomo-pathological examination revealed a bronchogenic cyst. The evolution was favorable after the surgical procedure.
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Zhu X, Zhang L, Tang Z, Xing FB, Gao X, Chen WB. Mature mediastinal bronchogenic cyst with left pericardial defect: A case report. World J Clin Cases 2021; 9:11362-11368. [PMID: 35071567 PMCID: PMC8717515 DOI: 10.12998/wjcc.v9.i36.11362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/26/2021] [Accepted: 07/06/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Mediastinal bronchogenic cysts and pericardial defects are both rare. It is extremely rare that both occur simultaneously. To the best of our knowledge, this is the first case of a coexistent bronchogenic cyst and pericardial defect reported in China. We performed a literature review and found a relationship between bronchogenic cysts and pericardial defects, which further revealed the correlation between the bronchus and pericardium during embryonic development.
CASE SUMMARY A 14-year-old boy attended a local hospital for ankylosing spondylitis. Chest radiography showed an enhanced circular-density shadow near the left mediastinum. The patient had no chest symptoms and the physical examination was normal. Because of the mediastinal occupation, the patient visited our department of chest surgery for further treatment. During surgery, a left pericardial defect was observed. The bronchogenic cyst was removed by thoracoscopic surgery, but the pericardial defect remained untreated, and a satisfactory outcome was achieved after the operation. The patient was diagnosed with a mediastinal tumor. The pathological diagnosis of the tumor was a bronchogenic cyst.
CONCLUSION This case further reveals the correlation between the bronchus and pericardium during embryonic development.
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Affiliation(s)
- Xiao Zhu
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, Anhui Province, China
| | - Lei Zhang
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, Anhui Province, China
| | - Zhen Tang
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, Anhui Province, China
| | - Fu-Bao Xing
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, Anhui Province, China
| | - Xiong Gao
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, Anhui Province, China
| | - Wen-Bang Chen
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, Anhui Province, China
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Clementino-Filho J, Surjan RCT, Taglieri E, Ardengh JC. Retroperitoneal Bronchogenic Cyst Mimicking a Pancreatic Cystic Lesion with Extremely High Level of Intralesional Fluid CA-19.9 Antigen: Benign in Disguise. Indian J Surg 2021;:1-6. [PMID: 34848933 DOI: 10.1007/s12262-021-03137-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 09/25/2021] [Indexed: 10/26/2022] Open
Abstract
Bronchogenic cysts are congenital benign tumors resulting from abnormal budding of the primitive foregut. Usually presented on the posterior mediastinum, its presence on the retroperitoneum is extremely rare. We present an asymptomatic lady patient with a retroperitoneal cystic lesion that was submitted to endoscopic ultrasound-guided biopsies and intracystic fluid aspiration with histology excluding malignance despite intracystic fluid biochemical analysis that disclosed extremely high carbohydrate antigen 19-9. Definite diagnosis of bronchogenic cyst was only possible after complete surgical resection of the lesion. Furthermore, we discuss the use of this antigen as a tumor marker in this situation and its relevance to the preoperative diagnosis of such lesions.
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Ishibashi H, Kato A, Sugita Y, Nakashima Y, Seto K, Wakejima R, Okubo K. Successful excision of a giant subcarinal bronchogenic cyst by video-assisted thoracoscopic surgery. Gen Thorac Cardiovasc Surg 2021; 70:197-200. [PMID: 34729684 DOI: 10.1007/s11748-021-01729-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 10/22/2021] [Indexed: 10/19/2022]
Abstract
Mediastinal bronchogenic cysts, regarded as congenital foregut abnormalities, are uncommon. These cysts can compress adjacent structures, causing obstructive symptoms and complications. A 57-year-old man was admitted to our hospital with complaints of tachycardia, dyspnea, and chest pain. Enhanced computed tomography revealed a 90 × 90 mm, well-defined subcarinal cystic mass causing significant compression and stenosis of the right main bronchus, right pulmonary artery, and right inferior pulmonary vein. The mass was successfully excised using one window and two-port video-assisted thoracoscopic surgery with partial resection and repair of pulmonary artery, and the postoperative course was good with no recurrence.
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Affiliation(s)
- Hironori Ishibashi
- Department of Thoracic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
| | - Airi Kato
- Department of Thoracic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Yusuke Sugita
- Department of Thoracic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Yasuhiro Nakashima
- Department of Thoracic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Katsutoshi Seto
- Department of Thoracic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Ryo Wakejima
- Department of Thoracic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Kenichi Okubo
- Department of Thoracic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
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Yuan K, Shu M, Ma Y, Feng W, Ye J, Yuan Y. Ectopic bronchogenic cyst in the retroperitoneal region: a case report and literature review of adult patients. BMC Surg 2021; 21:347. [PMID: 34544401 PMCID: PMC8454181 DOI: 10.1186/s12893-021-01341-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 09/06/2021] [Indexed: 12/18/2022] Open
Abstract
Background Bronchogenic cyst is congenital aberration of bronchopulmonary malformation, which is rarely encountered in the abdomen and retroperitoneum. We present a case report and literature review of retroperitoneal bronchogenic cyst. Case presentation A 53-year-old female presented to outpatient clinic for a routine checkup of lumbar intervertebral disc herniation. She received a contrast computed tomography scan of the abdomen which revealed a retroperitoneal cystic lesion below the left crura of diaphragm. Afterward, the patient underwent a laparoscopic excision of the cystic lesion and was discharged uneventfully at postoperative day 4. Histopathological findings confirmed the diagnosis of retroperitoneal bronchogenic cyst. Our literature review identified 55 adult cases in recent two decades. The average age at diagnosis was 43.2 (range 17–69) years. 44 (80%) cases had a retroperitoneal cyst on the left side, and 52 (94.5%) cases underwent curative excision through open or laparoscopic surgery. In the available follow up of cases, there was no recurrence after surgery. Conclusions Bronchogenic cyst is rare in the retroperitoneal region. It should be considered as one of the differential diagnoses of a retroperitoneal neoplasm.
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Affiliation(s)
- Kaitao Yuan
- Center of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-sen University, No. 58 2nd Zhongshan Road, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Man Shu
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Yan Ma
- Center of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-sen University, No. 58 2nd Zhongshan Road, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Weidong Feng
- Center of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-sen University, No. 58 2nd Zhongshan Road, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Jinning Ye
- Center of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-sen University, No. 58 2nd Zhongshan Road, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Yujie Yuan
- Center of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-sen University, No. 58 2nd Zhongshan Road, Guangzhou, 510080, Guangdong Province, People's Republic of China.
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Tang J, Zeng Z, Deng S, Lin F. Ectopic bronchogenic cyst arising from the diaphragm: a rare case report and literature review. BMC Surg 2021; 21:321. [PMID: 34376164 PMCID: PMC8353838 DOI: 10.1186/s12893-021-01317-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 08/02/2021] [Indexed: 02/08/2023] Open
Abstract
Background Bronchogenic cysts can be caused by errors in the growth of the ventral foregut. Localization of the bronchogenic cyst (BC) varies depending on the level of the abnormal budding. They are usually located in the lungs and mediastinum. BCs of the diaphragm are a rare form of this abnormality. Case presentation A 66-year-old woman coughs and expectorates. CT scan evaluation revealed a soft tissue shadow of 6 × 5 cm in the left lung. Under thoracoscopic surgery, we found that the mass originated from the diaphragm away from the lung tissue, we completely removed the mass and the pathological result was diagnosed as BC. Conclusions The prognosis of ectopic BC is usually optimistic for benign tumors, as long as the tumor is completely removed.
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Affiliation(s)
- Juan Tang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Sichuan, 610041, Chengdu, China
| | - Zhen Zeng
- Department of Thoracic Surgery, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Sichuan, 610041, Chengdu, China
| | - Senyi Deng
- Department of Thoracic Surgery, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Sichuan, 610041, Chengdu, China
| | - Feng Lin
- Department of Thoracic Surgery, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Sichuan, 610041, Chengdu, China.
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32
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Yanagisawa S, Wasamoto S. Luminal Findings of a Bronchogenic Cyst. Am J Respir Crit Care Med 2021; 204:e59-e60. [PMID: 33882265 DOI: 10.1164/rccm.202101-0127im] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Satoru Yanagisawa
- Tohoku University Graduate School of Medicine, Department of Respiratory Medicine, Sendai, Japan;
| | - Satoshi Wasamoto
- Saku Central Hospital Advanced Care Center, 423150, Department of Respiratory Medicine, Saku, Japan
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33
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Escalante JM, Molina G, Rincón FM, Acosta Buitrago LM, Perez Rivera CJ. Giant Intrapericardial bronchogenic cyst associated with congestive heart failure and atrial fibrillation: a case report. J Cardiothorac Surg 2021; 16:29. [PMID: 33740997 PMCID: PMC7980539 DOI: 10.1186/s13019-021-01412-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 03/10/2021] [Indexed: 11/29/2022] Open
Abstract
Background Large intracardiac bronchogenic cysts are rare mediastinal masses. However, they must always be considered in the differential diagnosis of heart failure with abnormal chest X-ray. Case presentation We present a 60-year-old female patient with de novo atrial fibrillation, heart failure and a very large intrapericardial mass. The patient underwent successful surgical resection, with pathological findings confirming a bronchogenic cyst. Conclusions Large bronchogenic cysts located intrapericardially are very rare. However, they should be included in the differential diagnosis of patients presenting with atrial fibrillation and heart failure with abnormal radiologic studies.
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Affiliation(s)
- Javier Maldonado Escalante
- Department of Cardiovascular Surgery, Clínica Universitaria Colombia, Carrera 23 #66-46, Bogota, DC, Colombia
| | - German Molina
- Department of Cardiovascular Surgery, Clínica Universitaria Colombia, Carrera 23 #66-46, Bogota, DC, Colombia
| | - Francisco Mauricio Rincón
- Department of Cardiovascular Surgery, Clínica Universitaria Colombia, Carrera 23 #66-46, Bogota, DC, Colombia
| | - Lina M Acosta Buitrago
- Department of Cardiovascular Surgery, Clínica Universitaria Colombia, Carrera 23 #66-46, Bogota, DC, Colombia
| | - Carlos J Perez Rivera
- Department of Cardiovascular Surgery, Clínica Universitaria Colombia, Carrera 23 #66-46, Bogota, DC, Colombia.
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Abstract
Bronchogenic cysts are foregut-derived developmental anomalies found along the developmental pathway of the foregut. The putative theory of pathogenesis is abnormal budding or branching of epithelial cells during the development of tracheobronchial tree. Over 99 % of cases occur in the mediastinum and lung while the head and neck area is affected in less than 1 % of cases with only rare cases reported in the oral cavity. This is a report of a case of a bronchogenic cyst arising in a 6-year-old male. The lesion presented as a painless swelling of the left underside of the tongue. Microscopically, the cyst was lined by pseudostratified columnar epithelium exhibiting many ciliated and mucous cells. A focus of cartilage and discontinuous bundles of smooth muscle were present adjacent to the lining. Where there was cyst rupture, there was granulation tissue associated with many foamy macrophages and acute and chronic inflammation. Four other cases, three in the tongue and one in the lower lip vestibule with cutaneous extension, all in the midline, have been reported in a 1 day-old male, 4 year-old male, 6 year-old female and 3 year-old male. There was no recurrence after excision and this is in keeping with the behavior in previous reports. Other developmental cysts including foregut cysts may be focally lined with respiratory epithelium but the presence of cartilage is the sine qua non for the diagnosis of a bronchogenic cyst.
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35
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Cassiani J, Crinò SF, Manfrin E, Rivelli M, Gabbrielli A, Guglielmi A, Pedrazzani C. Endoscopic Ultrasound Through-the-Needle Biopsy for the Diagnosis of an Abdominal Bronchogenic Cyst. Clin Endosc 2021; 54:767-770. [PMID: 33596637 PMCID: PMC8505176 DOI: 10.5946/ce.2020.195] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/17/2020] [Indexed: 01/01/2023] Open
Abstract
A 57-year-old woman with epigastric pain was diagnosed with a 6-cm abdominal cystic lesion of unclear origin on cross-sectional imaging. Endoscopic ultrasound (EUS) demonstrated a unilocular cyst located between the pancreas, gastric wall, and left adrenal gland, with a regular wall filled with dense fluid with multiple hyperechoic floating spots. A 19-G needle was used to puncture the cyst, but no fluid could be aspirated. Therefore, EUS-guided through-the-needle biopsy (EUS-TTNB) was performed. Histological analysis of the retrieved fragments revealed a fibrous wall lined by "respiratory-type" epithelium with ciliated columnar cells, consistent with the diagnosis of a bronchogenic cyst. Laparoscopic excision was performed, and the diagnosis was confirmed based on the findings of the surgical specimen. Abdominal bronchogenic cysts are extremely uncommon, and a definitive diagnosis is commonly obtained after the examination of surgical specimens due to the lack of pathognomonic findings on cross-sectional imaging and poor cellularity on EUS-guided fine-needle aspiration cytology. EUS-TTNB is useful for establishing a preoperative histological diagnosis, thus supporting the decision-making process.
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Affiliation(s)
- Jessica Cassiani
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Unit of General and Hepatobiliary Surgery, University of Verona Hospital Trust, University of Verona, Verona, Italy
| | - Stefano Francesco Crinò
- Department of Medicine, Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, University of Verona Hospital Trust, University of Verona, Verona, Italy
| | - Erminia Manfrin
- Department of Diagnostic and Public Health, University of Verona Hospital Trust, University of Verona, Verona, Italy
| | - Matteo Rivelli
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Unit of General and Hepatobiliary Surgery, University of Verona Hospital Trust, University of Verona, Verona, Italy
| | - Armando Gabbrielli
- Department of Medicine, Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, University of Verona Hospital Trust, University of Verona, Verona, Italy
| | - Alfredo Guglielmi
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Unit of General and Hepatobiliary Surgery, University of Verona Hospital Trust, University of Verona, Verona, Italy
| | - Corrado Pedrazzani
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Unit of General and Hepatobiliary Surgery, University of Verona Hospital Trust, University of Verona, Verona, Italy
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36
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Qingyu J, Xiaolong L, Ruohan Z, Licong M, Zhichao T, Qingwei C, Yuan W, Ying Z. Computed tomography helps pre-operative evaluation before laparoscopic resection of retroperitoneal bronchogenic cyst: A case report. J Minim Access Surg 2021; 17:95-97. [PMID: 32964892 PMCID: PMC7945650 DOI: 10.4103/jmas.jmas_72_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Bronchogenic cysts are congenital foregut dysplasia that occur mostly in the lungs and mediastinum. Here, we report a rare case of retroperitoneal bronchogenic cyst, the location, relationship to adjacent structures and blood supply of which were determined by computed tomography (CT) recombination technology and resected by laparoscope. The case was a 41-year-old female patient. The patient came to the hospital because of intermittent lumbar back discomfort for 1 month. CT scanning revealed a cystic mass of 3.9 cm × 3.2 cm × 3.0 cm behind the left peritoneum. The mass was close to the left adrenal gland, and a branch artery from the left renal artery was revealed to supply the mass. The cystic mass was excised by laparoscopy and confirmed as bronchogenic cyst on histopathology.
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Affiliation(s)
- Ji Qingyu
- Department of Radiology, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, China
| | - Li Xiaolong
- Surgical Minimally Invasive Center, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, China
| | - Zhu Ruohan
- Department of Ultrasound, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, China
| | - Ma Licong
- Department of Pathology, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, China
| | - Tang Zhichao
- Department of Radiology, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, China
| | - Chen Qingwei
- Department of Radiology, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, China
| | - Wang Yuan
- Department of Ultrasound, The Maternal and Child Health Center of Baotou City, Baotou, China
| | - Zhao Ying
- Department of Radiology, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, China
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Zarogoulidis P, Tsakiridis K, Vagionas A, Hohenforst-Schmidt W, Zaric B, Tryfon S, Saroglou M, Drevelegas K, Hatzibougias D, Michalopoulou-Manoloutsiou E, Paliouras D, Barbetakis N, Huang H, Bai C. Bronchogenic cyst or lung cancer. Only biopsy can tell. Respir Med Case Rep 2020; 32:101328. [PMID: 33457198 PMCID: PMC7797910 DOI: 10.1016/j.rmcr.2020.101328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 12/27/2020] [Indexed: 11/29/2022] Open
Abstract
Bronchogenic cysts are rare congenital malformations which derive from primitive ventral foregut. They are usually observed in intrathoracically. A fifty year old male was admitted for the investigation of a three month chest pain. Computed tomography scan of the thorax revealed a lesion around the esophagus and left stem bronchus. Endobronchial ultrasound with convex probe and a 19G needle biopsy revealed a bronchogenic cystic which was removed with video assisted thoracic surgery. Initial radiologic assessment although was thought to be lung cancer because of the smoking habit it turned out to be benignancy. EBUS-TBNAB with 10G needle is safe and absolutely necessary for these lesions, as they take large samples.
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Affiliation(s)
- Paul Zarogoulidis
- 3rd University General Hospital, ''AHEPA'' University Hospital, Thessaloniki, Greece
| | - Kosmas Tsakiridis
- Thoracic Surgery Department, ''Interbalkan'' European Medical Center, Thessaloniki, Greece
| | | | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, "Hof" Clinics, University of Erlangen, Hof, Germany
| | - Bojan Zaric
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Stavros Tryfon
- Pulmonary Department (NHS), ''G. Papanikolaou'' General Hospital, Thessaloniki, Greece
| | - Maria Saroglou
- Pulmonary Department (NHS), ''G. Papanikolaou'' General Hospital, Thessaloniki, Greece
| | | | | | | | - Dimitris Paliouras
- Thoracic Surgery Department, ''Theageneio'' Cancer Hospital, Thessaloniki, Greece
| | - Nikolaos Barbetakis
- Thoracic Surgery Department, ''Theageneio'' Cancer Hospital, Thessaloniki, Greece
| | - Haidong Huang
- Department of Respiratory Medicine, Changhai Hospital of Second Military Medical University, Shanghai, China
| | - Chong Bai
- Department of Respiratory Medicine, Changhai Hospital of Second Military Medical University, Shanghai, China
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38
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Bakshi N, Dhawan S, Sengar P, Dhir U. Neuroendocrine tumor in a lesser sac bronchogenic cyst - A hitherto unreported entity made rarer by concomitant hepatic hydatid cyst. Indian J Cancer 2020; 57:205-208. [PMID: 32445326 DOI: 10.4103/ijc.ijc_749_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Intra-abdominal bronchogenic cysts are rare entities and only a handful of cases occurring within the lesser sac have been described. Further, the development of malignancy in a bronchogenic cyst is exceptional and one arising in a lesser sac has so far not been reported. We present herein an account of a 44-year-old man who presented with recurrent upper abdominal pain. Investigations revealed a mass in the lesser sac and a hydatid cyst in the liver. The histopathological examination of the excised mass showed bronchogenic cyst, with a neuroendocrine tumor of intermediate grade arising in its wall. Concomitant presence of hydatid cyst in the liver made this case even more unusual.
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Affiliation(s)
- Neha Bakshi
- Department of Pathology, Sir Ganga Ram Hospital, Rajender Nagar, New Delhi, India
| | - Shashi Dhawan
- Department of Pathology, Sir Ganga Ram Hospital, Rajender Nagar, New Delhi, India
| | - Pratishtha Sengar
- Department of Pathology, Sir Ganga Ram Hospital, Rajender Nagar, New Delhi, India
| | - Ushast Dhir
- Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, Rajender Nagar New Delhi, India
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39
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Rubicondo C, Lovece A, Pinelli D, Indriolo A, Lucianetti A, Colledan M. Endoluminal vacuum-assisted closure (E-Vac) therapy for postoperative esophageal fistula: successful case series and literature review. World J Surg Oncol 2020; 18:301. [PMID: 33189152 PMCID: PMC7666449 DOI: 10.1186/s12957-020-02073-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/28/2020] [Indexed: 12/05/2022] Open
Abstract
Background Treatment of esophageal perforations and postoperative anastomotic leaks of the upper gastrointestinal tract remains a challenge. Endoluminal vacuum-assisted closure (E-Vac) therapy has positively contributed, in recent years, to the management of upper gastrointestinal tract perforations by using the same principle of vacuum-assisted closure therapy of external wounds. The aim is to provide continuous wound drainage and to promote tissue granulation, decreasing the needed time to heal with a high rate of leakage closure. Cases presentation A series of two different cases with clinical and radiological diagnosis of esophageal fistulas, recorded from 2018 to 2019 period at our institution, is presented. The first one is a case of anastomotic leak after esophagectomy for cancer complicated by pleuro-mediastinal abscess, while the second one is a leak of an esophageal suture, few days after resection of a bronchogenic cyst perforated into the esophageal lumen. Both cases were successfully treated with E-Vac therapy. Conclusion Our experience shows the usefulness of E-Vac therapy in the management of anastomotic and non-anastomotic esophageal fistulas. Further research is needed to better define its indications, to compare it to traditional treatments and to evaluate its long-term efficacy.
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Affiliation(s)
| | - Andrea Lovece
- General Surgery I, ASST Papa Giovanni XXIII, Piazza OMS, 1, 24127, Bergamo, Italy
| | | | - Amedeo Indriolo
- Department of Gastroenterology and Endoscopy, ASST Papa Giovanni XXIII, Bergamo, Italy
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Hiremath CS, Kumar D, Doddamane AN, Kamath A. Management of infected recurrent mediastinal bronchogenic cyst with tuberculous mediastinal lymphadenitis. Indian J Thorac Cardiovasc Surg 2020; 36:67-70. [PMID: 33061098 DOI: 10.1007/s12055-019-00850-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 07/01/2019] [Accepted: 07/10/2019] [Indexed: 10/26/2022] Open
Abstract
We describe a case of a 20-year-old woman with recurrent bronchogenic cyst. The cyst made its debut at the age of six, which was excised surgically. Preoperative investigations revealed a mass in the right parasternal region extending from around the pericardium, present between the second and fourth ribs and abutting the right mediastinal structures. Dense adhesions were noted and released selectively to avoid iatrogenic injury. Complete evacuation and excision of the cyst from around the pericardium and phrenic nerve with marsupialization of the sac were performed. The patient's post-operative course was uneventful.
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Affiliation(s)
| | - Dinesh Kumar
- Department of Cardiovascular and Thoracic Surgery, Sri Sathya Sai Institute of Higher Medical Sciences (SSSIHMS), Bangalore, India
| | - Aditya Narsipur Doddamane
- Department of Cardiovascular and Thoracic Surgery, Sri Sathya Sai Institute of Higher Medical Sciences (SSSIHMS), Bangalore, India
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Abstract
Bronchogenic cyst (BC) is a very rare congenital anomaly occurring due to budding of the primitive foregut, and its common location is the posterior mediastinum. BC when diagnosed prenatally can be treated if it is encroaching on the development of lungs. BC has been reported in other locations such as cervical, thoracic, abdominal sites and also as subcutaneous lesions. Omphalocele is a congenital malformation occurring due to a central defect in the abdominal wall with herniation of the viscera. The nonentity documented here was found in a female fetus with 20 weeks of gestational age. The mother was a primigravida who had antenatal ultrasound scan rendering diagnosis of a live fetus having abdominal wall defect with omphalocele. This case is exceptionally rare as the content of omphalocele was BC having a classical wall lined by pseudostratified ciliated columnar epithelium overlying band-like cartilage. The extensive search in the literature did not reveal another similar case.
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Affiliation(s)
- Kusuma Venkatesh
- Department of Pathology, Kempegowda Institute of Medical Sciences, Bengaluru, Karnataka, India
| | - Karishma Pillarisetty
- Department of Pathology, Kempegowda Institute of Medical Sciences, Bengaluru, Karnataka, India
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Abstract
Pediatric cystic lung lesions have long been a source of confusion for clinicians, radiologists, and pathologists. They encompass a wide spectrum of entities with variable prognostic implications, including congenital lung malformations, pulmonary neoplasms, and hereditary conditions. As our understanding of the developmental and genetic origins of these conditions has evolved, revised nomenclature and classifications have emerged in an attempt to bring clarity to the origin of these lesions and guide clinical management. This review discusses cystic lung lesions and the current understanding of their etiopathogenesis.
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Affiliation(s)
- Nahir Cortes-Santiago
- Department of Pathology and Immunology, Baylor College of Medicine, BCM 315, One Baylor Plaza, Houston, TX 77030, USA; Department of Pathology, Texas Children's Hospital, 6621 Fannin Street Suite AB1195, Houston, TX 77030, USA
| | - Gail H Deutsch
- Department of Pathology, University of Washington School of Medicine, Seattle, WA, USA; Department of Laboratories, Seattle Children's Hospital, OC.8.720, 4800 Sand Point Way Northeast, Seattle, WA 98105, USA.
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Subramanian JB, K S S, Selvarangam S. A case report- retroperitoneal bronchogenic cyst in relation to the hindgut. Int J Surg Case Rep 2020; 75:140-2. [PMID: 32950943 DOI: 10.1016/j.ijscr.2020.09.038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/15/2020] [Accepted: 09/05/2020] [Indexed: 12/21/2022] Open
Abstract
Bronchogenic cysts are rare primitive foregut derived developmental aberrations in early embryonic life. Typically occur in the mediastinum. They arise from an abnormal budding of the tracheobronchial anlage. A Retroperitoneal location of bronchogenic cysts is exceptionally unusual. They are mostly asymptomatic. Due to continued epithelial secretion, these lesions have a tendency to become larger as the patients get older.
Introduction Bronchogenic cysts are developmental anomalies which occur as an abnormal budding of the primitive foregut or tracheobronchial tree. Bronchogenic cysts arise most often in the mediastinum. They can occur in many atypical locations. A retroperitoneal location is exceptionally unusual. Presentation of case We present the case of a 46-year-old male with complaints of dyspeptic symptoms, who, on routine evaluation was found to have a mass in the Left iliac fossa. The patient’s past medical and surgical history is unremarkable and had no history of trauma. The patient’s clinical examination was unremarkable except for mild tenderness in the Left iliac fossa. Routine Pre-operative Blood investigations were within normal limits. Computed Tomography showed 4 × 3.4 cm lesion on the anterior surface of the left psoas muscle just abutting the left ureter. A colonoscopy done revealed normal study. The tumour was excised in-toto through a retroperitoneal approach. Discussion Bronchogenic cysts are rare primitive foregut derived developmental aberrations in early embryonic life, typically occurring in the mediastinum. They arise from an abnormal budding of the tracheobronchial anlage of the primitive foregut between the 3rd and 7th weeks of development. Retroperitoneal bronchogenic cysts occur almost equally in men and women. CT and MRI are found to be ideal imaging modalities Surgical resection of these lesions is recommended. Laparoscopic surgery is preferred. Only one case of a retroperitoneal bronchogenic cyst associated with the development of adenocarcinoma has been reported. Conclusion The differential can be kept in mind when incidentally detected cysts are found during diagnostic imaging for other symptoms.
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Panichelli L, Salinas W, Napolitano D, Signorini F, Muñoz J. Intramural esophageal bronchogenic cyst. CIR CIR 2020; 88:94-97. [PMID: 32963406 DOI: 10.24875/ciru.20001701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Antecedentes Los quistes broncogénicos esofágicos son sacos cerrados originados de brotes anormales del tubo -traqueobronquial primitivo. Estas lesiones suelen ser asintomáticas, por lo que pueden hallarse incidentalmente o pueden causar síntomas por compresión de estructuras adyacentes. Son lesiones muy poco comunes; se han publicado unos 23 casos en adultos. Caso clínico Presentamos el caso de un varón de 44 años con un cuadro de tos de larga duración, sin otro síntoma. Para descartar las causas más comunes de sus síntomas se realizan estudios que objetivan la presencia de una lesión intramural de 40 × 43 mm. Se realiza videotoracoscopia para su resección y estudio, resultando ser un quiste broncogénico. Background Bronchogenic cysts are close sacks originated from abnormal development of the tracheobronchial tree. These lesions are usually asymptomatic or can cause symptoms, by compression of adjacent structures. This pathology is so unusual that there are only about 23 cases published in adults. Case report We report a case of a 44 year-old man with persistent cough, without other symptom. The most common causes for his symptoms were ruled out, so imaging studies were made, showing at the medial portion of the esophagus, located intramural a 40 × 43 mm ovoid lesion. Resected by video-assisted thoracoscopy for its study. With findings attributable to bronchogenic cyst.
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Affiliation(s)
- Lucas Panichelli
- Servicio de Cirugía General, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - Walter Salinas
- Servicio de Cirugía General, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - Daniel Napolitano
- Servicio de Cirugía General, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - Franco Signorini
- Servicio de Cirugía General, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - Juan Muñoz
- Servicio de Cirugía General, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
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Lateef N, Kuniyoshi J, Latif A, Ahsan MJ, Shaikh K, DeVrieze B, Smer A, Aboeata A. Cardiac tamponade as a complication of bronchogenic cyst. Proc AMIA Symp 2020; 34:172-174. [PMID: 33456190 DOI: 10.1080/08998280.2020.1795594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Bronchogenic cysts are rare incidental findings, but they can have life-threatening complications. Herein, we report a case of a 44-year-old man who presented with complaints of left-sided chest pain, intermittent dyspnea, and pink-tinged sputum. Computed tomography angiography of the chest revealed a large cystic mediastinal mass in the subcarinal location. During his hospital stay, the patient became hypotensive with jugular venous distention and muffled heart sounds on auscultation. A stat echocardiogram depicted a large pericardial effusion with early diastolic collapse of the right ventricle. Pericardiocentesis was performed for cardiac tamponade, followed by thoracotomy with removal of bronchogenic cyst. Herein, we highlight the relation between bronchogenic cysts and cardiac tamponade and review the surgical treatment options.
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Affiliation(s)
- Noman Lateef
- Department of Internal Medicine, Creighton University Medical Center, Omaha, Nebraska
| | - Jason Kuniyoshi
- Department of Internal Medicine, Creighton University Medical Center, Omaha, Nebraska
| | - Azka Latif
- Department of Internal Medicine, Creighton University Medical Center, Omaha, Nebraska
| | - Muhammad Junaid Ahsan
- Department of Internal Medicine, Creighton University Medical Center, Omaha, Nebraska
| | - Kashif Shaikh
- Department of Cardiovascular Medicine, Creighton University Medical Center, Omaha, Nebraska
| | - Bradley DeVrieze
- Department of Internal Medicine, Creighton University Medical Center, Omaha, Nebraska
| | - Aiman Smer
- Department of Cardiovascular Medicine, Creighton University Medical Center, Omaha, Nebraska
| | - Ahmed Aboeata
- Department of Cardiovascular Medicine, Creighton University Medical Center, Omaha, Nebraska
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Wang X, Li Y, Chen K, Yang F, Wang J. Clinical characteristics and management of primary mediastinal cysts: A single-center experience. Thorac Cancer 2020; 11:2449-2456. [PMID: 32677753 PMCID: PMC7471030 DOI: 10.1111/1759-7714.13555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/06/2020] [Accepted: 06/08/2020] [Indexed: 12/16/2022] Open
Abstract
Background In this study we aimed to assess the clinical outcomes of performing video‐assisted thoracic surgery (VATS) to treat primary mediastinal cysts (PMCs) and investigate the clinical factors which increase the difficulties associated with VATS. Methods The medical records of all consecutive PMC patients, who underwent surgical resection from April 2001 to July 2016, were reviewed and 282 patients were included. Clinical characteristics, imaging features, and surgical outcomes were analyzed. Follow‐up data were successfully obtained from 230 PMC patients by telephone or outpatient clinic annually. The latest follow‐up was July 2019. Results VATS was performed in 278 patients and four patients were converted into thoracotomy. The mean operation time and intraoperative bleeding were 102.4 ± 40.9 minutes (range 25–360 minutes) and 52.4 ± 75.1 mL (range 5–600 mL), respectively. The intra‐ and postoperative complication rates were 2.8 and 5.7%, respectively. Seven patients with bronchogenic cysts showed severe cyst adhesion to vital mediastinal structures and thus had incomplete resection. Multivariable logistic analysis revealed that a maximal cyst diameter greater than 5 cm was significantly associated with increased risks of operation time extension (OR = 2.106; 95% CI: 1.147–3.865, P = 0.016) and intraoperative blood loss increase (OR = 4.428; 95% CI: 1.243–16.489, P = 0.022). A total of 230 patients had follow‐up data. The median follow‐up time was 70 months (range, 36–210 months). No local recurrence was observed. Conclusions Surgical resection by VATS may be recommended for PMC management as a primary therapeutic strategy. Cysts with a maximum diameter greater than 5 cm or cysts adjacent to vital mediastinal structures can increase the surgical difficulties. Key points • Significant findings of the study A diameter >5 cm and adhesions significantly increased the risk of operation time extension together with increased blood loss. • What this study adds Cysts with a diameter >5 cm or those adjacent to vital mediastinal structures increased the potential for surgical difficulties.
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Affiliation(s)
- Xun Wang
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
| | - Yun Li
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
| | - Kezhong Chen
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
| | - Fan Yang
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
| | - Jun Wang
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
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Lee J, Chang JW. Bronchogenic cysts mimicking thymoma in the anterior mediastinum. Respirol Case Rep 2020; 8:e00583. [PMID: 32405416 PMCID: PMC7218296 DOI: 10.1002/rcr2.583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/22/2020] [Accepted: 04/28/2020] [Indexed: 12/19/2022] Open
Abstract
Bronchogenic cysts are commonly located in the middle mediastinal compartment as fluid-filled cysts and thymoma is one of the most common neoplasms in the anterior mediastinum in adult cases. For two cases of asymptomatic, incidentally discovered anterior mediastinal soft tissue mass in adults, we planned to perform complete thymectomy with minimally invasive techniques based on the guidelines of International Thymic Malignancy Interest Group. Their pathological finding revealed cystic lesions lined by ciliated epithelium and this supported the diagnosis of bronchogenic cyst rather than thymic neoplasm. We report the two cases of resected bronchogenic cysts which were in the unusual location of anterior mediastinum with uncommon radiological feature.
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Affiliation(s)
- Jonggeun Lee
- Department of Thoracic and Cardiovascular Surgery, School of MedicineJeju National University Hospital, Jeju National UniversityJejuSouth Korea
| | - Jee Won Chang
- Department of Thoracic and Cardiovascular Surgery, School of MedicineJeju National University Hospital, Jeju National UniversityJejuSouth Korea
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Alqassieh R, Al-Balas M, Al-Balas H. Anesthetic and surgical considerations of giant pericardial cyst: Case report and literature review. Ann Med Surg (Lond) 2020; 55:275-279. [PMID: 32547739 PMCID: PMC7286924 DOI: 10.1016/j.amsu.2020.05.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction Pericardial cysts are considered as a rare congenital abnormality, mostly found incidentally. The estimated incidence of pericardial cyst is 1:100,000 and represent approximately 6% of all mediastinal masses. Patients can present with symptoms similar to acute chest pain or right-sided heart failure or can be asymptomatic. Presentation A 46-year-old female who is known to have hypertension and hypothyroidism presented to the breast clinic with left breast mass that was proved by core needle biopsy as proliferative breast lesion. During the preoperative assessment, the patient reported progressive shortness of breath and cough over the last two years and bilateral lower limb edema. Her preoperative chest X-ray showed a well-defined oval like opacification at the right cardiophrenic angle that was proved by chest computed tomography imaging as a cystic mass od most likely a pericardial origin. A huge pericardial cyst originating from the right diaphragmatic surface was excised through a mini-sternotomy incision with smooth postoperative recovery. The patient-reported significant improvement in her symptoms and her lifestyle during her follow up. Discussion Pericardial cysts represent 6%-7% of all mediastinal masses with an estimated incidence of 1:100,000. About 70% of pericardial cysts originate at the right cardiophrenic angle and less frequently at the left cardiophrenic angle, they are usually suspected when the chest x-ray shows an enlarged contour of the right heart border. Mediastinal cysts have many differential diagnoses and the preoperative decision might be challenging in many cases. Pericardial cysts appear as oval, thin-walled homogeneous masses on cardiac computed tomography. The choice between surgical intervention and conservative follow up is related mainly to the size and symptoms that are induced by the cyst. Conclusion As pericardial cysts are rarely diagnosed pathology, a high index of suspicion is essential for diagnosis. Surgical resection is indicated when they are huge, enlarging in size or symptomatic. Morbidity and mortality risks following pericardial cyst excision are very low.
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Affiliation(s)
| | - Mahmoud Al-Balas
- Corresponding author. Irbid-Amman Street, P.O. Box 3, 21510, Al Husn, Irbid, Jordan.
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Stewart BD, VandenBussche CJ, Leon ME. Benign lesions of the mediastinum: A review with emphasis on cytology and small biopsy specimens. Semin Diagn Pathol 2020; 37:199-210. [PMID: 32534865 DOI: 10.1053/j.semdp.2020.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 04/01/2020] [Indexed: 01/03/2023]
Abstract
This review focuses on the diagnosis of select benign processes, ranging from reactive entities to heterotopic tissues to neoplasms, which may occur in the mediastinum. Currently, the mediastinum can be evaluated and biopsied with endoscopic procedures. Therefore, cytopathology specimens, fine needle aspirations, and small biopsies play an important role in the diagnosis of these lesions. In this review, an emphasis is given to relevant clinical presentations, histologic and cytologic findings, differential diagnoses, ancillary testing, and interpretation. Pitfalls are reviewed and discussed in each section. It is important for both surgical pathologists and cytopathologists to be familiar with these entities and their cytologic and histologic features that may be helpful in reaching a diagnosis.
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Affiliation(s)
- Brian D Stewart
- University of Florida College of Medicine Department of Pathology, Immunology and Laboratory Medicine P.O. Box 100275 1600 SW Archer Road Gainesville, FL 32610-0275.
| | - Christopher J VandenBussche
- Johns Hopkins University School of Medicine, Department of Pathology, 600 N. Wolfe Street Baltimore, MD 21287
| | - Marino E Leon
- University of Florida College of Medicine Department of Pathology, Immunology and Laboratory Medicine P.O. Box 100275 1600 SW Archer Road Gainesville, FL 32610-0275
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He WT, Deng JY, Liang H, Xiao JY, Cao FL. Bronchogenic cyst of the stomach: A case report. World J Clin Cases 2020; 8:1525-1531. [PMID: 32368546 PMCID: PMC7190944 DOI: 10.12998/wjcc.v8.i8.1525] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 03/27/2020] [Accepted: 04/09/2020] [Indexed: 02/05/2023] Open
Abstract
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 first reported in 1956; as of 2019, only 37 cases are available in the MEDLINE/PubMed online databases. BCs usually have no clinical symptoms in the early stage, and their imaging findings also lack specificity. Therefore, they are difficult to diagnose before histopathological examination.
CASE SUMMARY A 55-year-old woman presented at our hospital with intermittent epigastric pain. She had a slightly high level of serum carbohydrate antigen 72-4 (CA 72-4). Endoscopic ultrasound found that a cystic mass originated from the submucosa of the posterior gastric wall near the cardia, indicating a diagnosis of cystic hygroma of the stomach. Furthermore, a computed tomography scan demonstrated a quasi-circular cystic mass closely related to the lesser curvature of the gastric fundus with a low density. Because the imaging examinations did not suggest a malignancy and the patient required complete resection, she underwent laparoscopic surgery. As an intraoperative finding, this cystic lesion was located in the posterior wall of the fundus and contained some yellow viscous liquid. Finally, the pathologists verified that the cyst in the fundus was a gastric BC. The patient recovered well with normal CA 72-4 levels, and her course was uneventful at 10 mo.
CONCLUSION This is a valuable report as it describes an extremely rare case of gastric BC. Moreover, this is the first case of BC to present with elevated CA 72-4 levels.
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Affiliation(s)
- Wen-Ting He
- Department of Gastroenterology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, and Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China
| | - Jing-Yu Deng
- Department of Gastroenterology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, and Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China
| | - Han Liang
- Department of Gastroenterology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, and Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China
| | - Jian-Yu Xiao
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, and Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China
| | - Fu-Liang Cao
- Department of Endoscopy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, and Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China
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