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Khan Z, Batchelor T, Rees P. Bronchogenic cyst: a rare cause of palpitations and atrial fibrillation. BMJ Case Rep 2024; 17:e259480. [PMID: 38442975 PMCID: PMC11107077 DOI: 10.1136/bcr-2023-259480] [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: 02/14/2024] [Indexed: 03/07/2024] Open
Abstract
Bronchogenic cysts are rare congenital lesions found primarily in the mediastinum. Most patients are asymptomatic and can be treated with minimally invasive resection. We present a case of a middle-aged patient who presented to a district general hospital with palpitations and shortness of breath. She underwent a computerised tomographic pulmonary angiogram that showed a likely bronchogenic cyst and was subsequently transferred to our hospital. She developed atrial fibrillation during admission requiring therapy with beta-blockers and digoxin. Cardiac MRI revealed a large cyst posterior to the left atrium, a moderate circumferential pericardial effusion and bilateral pleural effusions. There was significant left atrial compression. The patient underwent surgical removal of the cyst and was discharged. She returned to the hospital within a week with palpitations and was treated with intravenous antibiotics for sepsis. She was discharged a week later and remained clinically stable.
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Affiliation(s)
- Zahid Khan
- Cardiology, Barts Health NHS Trust, London, UK
- Cardiology & Medical Education, University of South Wales, Pontypridd, UK
| | - Tim Batchelor
- Cardiothoracic Surgery, Barts Health NHS Trust, London, UK
| | - Paul Rees
- Queen Mary University of London, Queen Mary University of London Blizard Institute, London, UK
- Academic Department of Military Medicine, London, UK
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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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Ma TT, Chen G, Wang D, Xu H, Zhang JG. Clinical and imaging characteristics of patients with bronchogenic cysts: a single-center retrospective analysis. BMC Med Imaging 2023; 23:128. [PMID: 37710169 PMCID: PMC10503098 DOI: 10.1186/s12880-023-01042-1] [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: 10/20/2022] [Accepted: 06/05/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Bronchogenic cysts (BCs) are rare and usually asymptomatic malformations detected during imaging examinations. We aimed to investigate the clinical and imaging characteristics of patients with BCs. METHODS We retrospectively evaluated patients who received surgery to remove their BCs from January 2015 to January 2019. Their baseline characteristics, clinical information, and imaging results were reviewed. RESULTS Our study included 129 patients, with 57 males and 72 females and a mean age of 42.7 years old. The most common location for BCs was the mediastinum (67 patients, 51.9%). Fewer than half of the patients (53 patients, 41.1%) reported clinical symptoms, with chest pain being the most common (16 patients, 30.2%). Neck BCs were more frequently observed in young patients (P = 0.002) and were more often associated with thyroid cancer (P = 0.007). A computed tomography scan was the most commonly used method to diagnose BCs in the lung and mediastinum, whereas ultrasound was the most commonly used diagnostic method for neck BCs. The characteristic images were well-defined, thin-wall cystic lesions in varying densities. A few lesions showed small, calcified spots along the rim or cavities. CONCLUSIONS Although most BCs were found in the mediastinum, their locations could vary in different sex and age groups. Particular attention should be paid to young patients with BCs in the neck to rule out thyroid cancer.
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Affiliation(s)
- Tan-Tan Ma
- Department of Gastroenterology, The First Hospital of Jilin University, 71 Xinmin Street Changchun, Jilin, 130021, China
| | - Geng Chen
- Department of Gastroenterology, The First Hospital of Jilin University, 71 Xinmin Street Changchun, Jilin, 130021, China
| | - Dan Wang
- Department of Gastroenterology, The First Hospital of Jilin University, 71 Xinmin Street Changchun, Jilin, 130021, China
| | - Hong Xu
- Department of Gastroenterology, The First Hospital of Jilin University, 71 Xinmin Street Changchun, Jilin, 130021, China.
| | - Jian-Guang Zhang
- Department of Gastroenterology, The First Hospital of Jilin University, 71 Xinmin Street Changchun, Jilin, 130021, China.
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Vy TT, Bang HT, Trong VD, Tan NM, Cuong LT. Percutaneous aspiration and absolute ethanol sclerotherapy in the treatment of symptomatic bronchogenic cyst. Radiol Case Rep 2023; 18:1844-7. [PMID: 36923392 DOI: 10.1016/j.radcr.2023.02.010] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 03/07/2023] Open
Abstract
Surgical treatment is indicated for both symptomatic and asymptomatic bronchogenic cysts. The goal of treatment is total removal of the cyst. Percutaneous aspiration and absolute ethanol sclerotherapy is an effective, minimally invasive, and safe alternative method. We present the case of a 74-year-old woman with a symptom of persistent dry cough for 5 months. Plain and contrast-enhanced chest computed tomography revealed a large superior mediastinal cyst that could be easily accessed percutaneously. The cyst was treated by aspiration and ethanol sclerotherapy under ultrasound guidance and fluoroscopy. The patient was discharged a day later without complications. Chest CT at 6 months follow-up showed complete regression of the cyst.
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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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Choudhury MSR, Khan MYA, Shidham VB. Cytopathologic evaluation of a subcarinal lesion presenting as mass in a smoker. Cytojournal 2023; 20:1. [PMID: 36751554 PMCID: PMC9899454 DOI: 10.25259/cytojournal_33_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/03/2022] [Indexed: 01/14/2023] Open
Affiliation(s)
- Moumita Saha Roy Choudhury
- Department of Pathology, Wayne State University, Detroit, Michigan, United States.,Corresponding author: Moumita Saha Roy Choudhury, Department of Pathology, Wayne State University, Detroit, Michigan, United States.
| | | | - Vinod B. Shidham
- Department of Pathology, Wayne State University, Detroit, Michigan, United States
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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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Chu T, Yang M. Cellular transformation may be a most promising approach for the treatment of diseases: A hypothesis. Med Hypotheses 2022. [DOI: 10.1016/j.mehy.2022.110917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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