Endoscopic Ultrasound Through-the-Needle Biopsy for the Diagnosis of an Abdominal Bronchogenic Cyst.

Published on Feb 17, 2021in Clinical Endoscopy
· DOI :10.5946/CE.2020.195
Jessica Cassiani (University of Verona), Stefano Francesco Crinò14
Estimated H-index: 14
(University of Verona)
+ 4 AuthorsCorrado Pedrazzani33
Estimated H-index: 33
(University of Verona)
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.
#1Matteo Tacelli (University of Palermo)H-Index: 5
#2Ciro Celsa (University of Palermo)H-Index: 10
Last. Stefano Francesco CrinòH-Index: 14
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OBJECTIVES: Endoscopic ultrasound through-the-needle biopsy (EUS-TTNB) is a useful tool for differential diagnosis among pancreatic cystic lesions (PCLs). Cystic fluid cytology (CFC) is recommended by guidelines, but its diagnostic accuracy is about 50%. The aim of this meta-analysis is to assess the clinical impact of EUS-TTNB in terms of technical success (TS), histological accuracy (HA) and diagnostic yield (DY). METHODS: Original studies in English language on EUS-TTNB were searched in MEDLI...
14 CitationsSource
Background and Aims EUS-guided through-the-needle biopsy (TTNB) sampling has been reported to improve diagnostic yield compared with cytology for the evaluation of pancreatic cystic lesions (PCLs). The number of macroscopically visible tissue samples needed to reach an adequate diagnosis is still unknown. Methods This is a retrospective, single-center study on consecutive patients with PCLs with risk features (cyst >3 cm, thickened wall, cyst growth during follow-up, and mural nodules) who under...
24 CitationsSource
#1Alberto LarghiH-Index: 30
#2Erminia ManfrinH-Index: 24
Last. Adele FornelliH-Index: 16
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Abstract Background and Aims The recent development of microforceps for endoscopic ultrasound (EUS) through-the-needle biopsy (TTNB) of the wall of pancreatic cystic lesions (PCLs) allows to acquire histological specimens, which pathologists never handled and evaluated before. We aimed to estimate the interobserver agreement among pathologists in evaluating such samples. Methods TTNB slides from 40 PCLs with worrisome features were retrieved and independently evaluated for specimen adequacy, pre...
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#1Duygu Herek (Pamukkale University)H-Index: 10
#2Halil Erbiş (Pamukkale University)H-Index: 5
Last. Ahmet Baki Yagci (Pamukkale University)H-Index: 3
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Bronchogenic cyst is a benign lesion which is commonly seen in the posterior mediastinum. Diaphragmatic origin in retroperitoneum is an unusual location for a bronchogenic cyst. Cross-sectional imaging modalities describe the origin and content of the cyst evidently. Magnetic resonance (MR) images of a 42-year-old male patient who attended ER with back pain revealed a huge retroperitoneal complicated bronchogenic cyst arising from the diaphragm and surrounding the abdominal aorta anteriorly. Bro...
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#1Alexandre KlamtH-Index: 1
#2Adriana Di LoretoH-Index: 1
Last. Carlos Robles-MedrandaH-Index: 10
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The differentiation between a solid and cystic lesion is not always easy. EUS has provided a minimally invasive approach to the diag­nosis of benign mediastinal cysts. Our report describes two cases of intramural bronchogenic cysts and reviews the role of EUS in dealing with such cases. We conclude that the bronchogenic cysts are still a challenge despite evolution of the imaging studies.
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Last. Hiromasa Ohira (Fukushima Medical University)H-Index: 30
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We report a case of a gastric bronchogenic cyst diagnosed via endosonographically guided fine-needle aspiration (EUS-FNA) biopsy. A 60-year-old woman was referred to our hospital for an endoscopic ultrasound (EUS) examination because of a gastric subepithelial lesion detected by upper gastrointestinal endoscopy. EUS examination revealed a lesion that appeared to originate from the gastric submucosa but seemed to extend beyond the gastric wall. The latter finding raised concerns that the lesion m...
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#2D. W. Pilling (Boston Children's Hospital)H-Index: 1
Bronchopulmonary foregut malformations (BPFM) are a heterogeneous group of pulmonary developmental anomalies that present at varying ages and with overlapping symptoms, signs and radiology. This article discusses the embryology of these lesions with reference to possible common origins and the link between aetiology and radiological appearance. The radiology of each lesion, both antenatally and postnatally, is described and illustrated. A number of quandaries exist in the prediction of prognosis...
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#1Kinjiro Sumiyoshi (Kyushu University)H-Index: 6
#2Shuji Shimizu (Kyushu University)H-Index: 2
Last. Katsuhiko Kawakami (Kyushu University)H-Index: 4
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A bronchogenic cyst was found in the abdomen, in the retroperitoneum adjacent to the superior pancreatic body. The cyst was unilocular and contained about 100 ml pale yellow mucinous fluid. Microscopic examination revealed a pseudostratified columnar ciliated or cuboidal epithelium, seromucous glands, smooth muscle and cartilage, the distinctive features of bronchogenic cysts. This aberrant location of the cyst is explicable if abnormal buds of the tracheobronchial tree are pinched off and migra...
67 CitationsSource
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