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      Bronchogenic cyst of the stomach: A case report

      case-report

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          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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          Most cited references19

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          Clinical spectrum of mediastinal cysts.

          Congenital cysts of the mediastinum are an uncommon but important diagnostic group, representing 12 to 30% of all mediastinal masses. The purpose of this study was to review our institutional experience with congenital cysts of the mediastinum, emphasizing the clinical spectrum of the disease. Retrospective study. University hospital unit of general thoracic surgery. We retrospectively reviewed the records of 105 patients with cysts of the mediastinum (50 male and 55 female patients) who comprised 13.0% of mediastinal masses over the past 50 years. There were 10 pediatric patients (< 15 years old) and 95 adult patients. The prevalence of cysts in the adult populations was higher than that in children (14.1% vs 7.7%, p < 0.05). There were 47 bronchogenic cysts, 30 thymic cysts, 12 pericardial cysts, 7 pleural cysts, 4 esophageal duplications, 2 meningoceles, 1 thoracic duct cyst, and 2 others. MRI has become a useful tool for providing supplemental data in combination with CT. Overall, 38 patients (36.2%) with mediastinal cysts were symptomatic, including 39.2% with bronchogenic/esophageal cysts, 40% with thymic cysts, and 15.8% with pericardial/pleural cysts. One hundred patients had complete resection of their masses, 3 patients with pericardial diverticulum received a thoracoscopic fenestration without mortality, and 2 patients refused surgery. Early recognition of these relatively rare lesions would lead to immediate and appropriate surgical intervention. Early surgical intervention is also important because definitive histologic diagnosis can only be established by means of surgical extirpation.
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            Histopathological classification of nonneoplastic and neoplastic gastrointestinal submucosal lesions.

            This article provides an overview of the histopathologically defined nonneoplastic and neoplastic entities involved in submucosal lesions (SMLs) of the gastrointestinal tract, particularly those in the upper gastrointestinal tract. The gross appearance and the histomorphological and cytomorphological features of the most frequent SMLs are described, including gastrointestinal stromal tumor (GIST), leiomyoma, lipoma, carcinoid, granular-cell tumor, glomus tumor, schwannoma, submucosal metastases, Brunner's gland hamartoma, pancreatic rests, and cysts. The current state of important technical aspects of biopsy processing and the role of histology and cytology in the diagnosis of SMLs are discussed.
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              Gastric bronchogenic cyst diagnosed by endosonographically guided fine needle aspiration biopsy.

              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 might represent a cystic neoplasm rather than a simple cyst. Subsequently, EUS-FNA was performed to establish a definitive diagnosis and to guide further management. Cytologic evaluation of aspirated material revealed the presence of benign-appearing ciliated columnar epithelial cells within a mucinous background. Based on imaging and EUS-FNA findings, a diagnosis of gastric bronchogenic cyst was made and surgical resection was avoided. (c) 2008 Wiley Periodicals, Inc. J Clin Ultrasound, 2008.
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                Author and article information

                Contributors
                Journal
                World J Clin Cases
                WJCC
                World Journal of Clinical Cases
                Baishideng Publishing Group Inc
                2307-8960
                26 April 2020
                26 April 2020
                : 8
                : 8
                : 1525-1531
                Affiliations
                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
                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. dengery@ 123456126.com
                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
                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
                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
                Author notes

                Author contributions: He WT was the major contributor in writing the manuscript and editing the pictures; Liang H advised the manuscript; Deng JY was involved in drafting, writing, and editing the manuscript, and reviewed the manuscript as corresponding author; Xiao JY and Cao FL contributed to providing results obtained by radiology and endoscopy; all authors read and approved the final manuscript.

                Supported by National Natural Science Foundation of China, No. 81572372; National Key Research and Development Program "Major Chronic Non-infectious Disease Research" , No. 2016YFC1303200; and National Key Research and Development Program "Precision Medicine Research", No. 2017YFC0908304.

                Corresponding author: Jing-Yu Deng, MD, PhD, Chief Doctor, Professor, 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, West Lake Road, Hexi District, Tianjin 300060, China. dengery@ 123456126.com

                Article
                jWJCC.v8.i8.pg1525
                10.12998/wjcc.v8.i8.1525
                7190944
                32368546
                40b18dbf-00ea-4fe4-a3a8-ea0a0ea8c1e5
                ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.

                This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

                History
                : 29 December 2019
                : 27 March 2020
                : 10 April 2020
                Categories
                Case Report

                bronchogenic cyst,stomach,submucosal lesion,endoscopic ultrasound-guided fine needle aspiration,endosonography,case report

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