Retroperitoneal bronchogenic cyst:A case report and review of literature

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 spaceoccupying 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.

Young patient with a giant gastric bronchogenic cyst:A case report and review of literature

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.

Optimal resection of gastric bronchogenic cysts based on anatomical continuity with adherent gastric muscular layer: A case report

BACKGROUND Bronchogenic cysts are congenital lesions requiring radical resection because of malignant potential.However,a method for the optimal resection of these cysts has not been completely elucidated.CASE SUMMARY Herein,we presented three patients with bronchogenic cysts that were located adjacent to the gastric wall and resected laparoscopically.The cysts were detected incidentally with no symptoms and the preoperative diagnosis was challenging to obtain via radiological examinations.Based on laparoscopic findings,the cyst was attached firmly to the gastric wall and the boundary between the gastric and cyst walls was difficult to identify.Consequently,resection of cysts alone caused cystic wall injury in Patient 1.Meanwhile,the cyst was resected completely along with a part of the gastric wall in Patient 2.Histopathological examination revealed the final diagnosis of bronchogenic cyst and revealed that the cyst wall shared the muscular layer with the gastric wall in Patients 1 and 2.In Patient 3,the cyst was located adjacent to the gastric wall but histopathologically originated from diaphragm rather than stomach.All the patients were free from recurrence.CONCLUSION The findings of this study state that a safe and complete resection of bronchogenic cysts required the adherent gastric muscular layer or full-thickness dissection,if bronchogenic cysts are suspected via pre-and/or intraoperative findings.

Bronchogenic cyst of the stomach:A case report

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.

Ectopic bronchogenic cyst of liver misdiagnosed as gallbladder diverticulum: A case report

BACKGROUND Ectopic bronchogenic cysts are a type of congenital cystic tumor that are extremely difficult to diagnose and can be ectopically located in various organs,with the possibility of malignant transformation. Here we report a case of an ectopic bronchogenic cyst in the liver initially misdiagnosed as a gallbladder diverticulum.CASE SUMMARY The patient was a middle-aged woman whose chief complaint was intermittent pain in the upper abdomen. Imaging examination revealed a cystic space in the left inner lobe of the liver. She was admitted to our hospital for treatment. Based on abdominal examination and imaging findings, the initial diagnosis was gallbladder diverticulum with cholestasis combined with chronic cholecystitis.However, following intraoperative observations and postoperative pathologic assessment, the diagnosis was revised to ectopic bronchogenic cyst of the liver.CONCLUSION Radiologists, hepatobiliary and pancreatic surgeons, gastrointestinal surgeons,urologists, and even neurosurgeons should be aware and consider a possible diagnosis of ectopic bronchogenic cysts, especially when other types of cyst,cystadenoma, and other diseases are excluded. The disease and its complications should be detected and correctly diagnosed and treated as early as possible in order to avoid adverse outcomes.

Increasing secondary bacterial infections with Enterobacteriaceae harboring bla_(CTX-M-15) and bla_(CMY-6) in patients with bronchogenic carcinoma:an emerging point of concern

Objective:To look for secondary bacterial infections in bronchogenic carcinoma（BCA） with resistant organisms harboring bla genes considering the paucity of relevant studies.Methods: A total of 137 confirmed cases of BCA and 34 healthy volunteers were studied for the occurrence and prevalence of blaCTX-M and and blaAmpC harboring-enterobacteriaceae.A subset of these patients（n=69） was previously reported for the secondary infection with the Aspergillus species. Bronchoalveolar lavages（BAL） were subjected for bacterial and fungal cultures and the bacterial isolates were screened by multiplex PCRs for the presence of blaCTX-M and blaAmpC.The isolates were also screened for the association of insertion sequence（IS26） by PCR and characterized by RAPD for any clonal relatedness.Results:A total of 143 bacterial isolates were obtained from 137 BAL specimens of BC,patients.The Enterobacteriaceae-isolates were multidrug-resistant showing concomitant resistance to fluoroquinolones and aminoglycosides.Both blaCTX-M and blaAmpC of CIT family were detected in 77.4%and 27.4%isolates,respectively.Sequencing revealed the presence of blaCTX-M-15 and blaCMY-6.Twenty one percent of the isolates were simultaneously harboring blaampC and blaCTX-M-15.IS26 PCR and RAPD typing revealed the presence of diverse bacterial population but no predominant clone was identified.The present study also suggests strong association of aspergillosis with lung cancer and further strengthens the potential use of non-validated serological tests suggested earlier.Conclusions:We emphasize that all patients of bronchogenic carcinoma should also be screened for secondary bacterial infections,along with secondary fungal infections,so as to introduce early and specific antimicrobial therapy and to prevent unwanted deaths.

Esophageal bronchogenic cyst excised by endoscopic submucosal tunnel dissection: A case report

BACKGROUND Esophageal bronchogenic cyst(EBC) is a rare congenital disease that is difficult to diagnose preoperatively, and treatment remains controversial.CASE SUMMARY We report a 53-year-old Chinese woman hospitalized in our hospital following the discovery of a submucosal protruding mass of the esophagus by upper endoscopy. A preliminary diagnosis of EBC was made by endoscopic ultrasonography(EUS), and treatment was accomplished by endoscopic submucosal tunnel dissection(ESTD). The pathological results verified the diagnosis. No scar changes or cystic lesion within the original lesion were found under EUS after a 3-mo follow-up.CONCLUSION EUS is valuable for the preliminary diagnosis of EBC and surveillance. ESTD is a safe and effective treatment for EBC. Further evaluation of complications and long-term follow-ups are required.

Abdominal bronchogenic cyst:A rare case report

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.

Mature mediastinal bronchogenic cyst with left pericardial defect: A case report

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.

Retroperitoneal tumor finally diagnosed as a bronchogenic cyst:A case report and review of literature

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.

Retroperitoneal bronchogenic cyst in suprarenal region treated by laparoscopic resection:A case report

BACKGROUND Bronchogenic cysts(BCs)are benign congenital foregut malformations that are mostly present in the mediastinum and pulmonary parenchyma but rarely seen in the retroperitoneum.CASE SUMMARY We report the case of 17-year-old girl who complained of epigastric pain.A cystic lesion was found in the left suprarenal region on spectral computed tomography.The ovoid,well-defined,and homogeneous cystic lesion revealed slightly enhancement on conventional imaging but no enhancement on 40 KeV virtual mono-energetic images.The iodine density value of the lesion was 0.001 mg/mL and the Z-effective value was 7.25,which were close to those of fluid material in in vitro experiments.Magnetic resonance imaging revealed a cystic mass of intermediate signal intensity on T1-weighted imaging and high signal intensity on T2-weighted imaging.A laparoscopic surgery was carried out.Intraoperatively,a cystic lesion with a smooth surface was found in the left retroperitoneum.And the cystic wall was completely resected after intracystic fluid was suctioned.The histopathological examination findings of the lesion were compatible with BC.The patient recovered uneventfully without sighs of recurrence during a 10-mo follow-up period.CONCLUSION Radiological examinations play a significant role in the diagnosis of suprarenal BCs and spectral images offer additional spectral parameters.Accurate preoperative diagnoses of retroperitoneal BCs based on thorough imaging examinations are beneficial to the operation of laparoscopic resection.

Bronchogenic cysts with infection in the chest wall skin of a 64-yearold asymptomatic patient: A case report

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.

Imaging diagnosis of bronchogenic carcinoma(the forgotten disease)during times of COVID-19 pandemic:Current and future perspectives

Patients with bronchogenic carcinoma comprise a high-risk group for coronavirus disease 2019(COVID-19),pneumonia and related complications.Symptoms of COVID-19 related pulmonary syndrome may be similar to deteriorating symptoms encountered during bronchogenic carcinoma progression.These resemblances add further complexity for imaging assessment of bronchogenic carcinoma.Similarities between clinical and imaging findings can pose a major challenge to clinicians in distinguishing COVID-19 super-infection from evolving bronchogenic carcinoma,as the above-mentioned entities require very different therapeutic approaches.However,the goal of bronchogenic carcinoma management during the pandemic is to minimize the risk of exposing patients to COVID-19,whilst still managing all life-threatening events related to bronchogenic carcinoma.The current pandemic has forced all healthcare stakeholders to prioritize per value resources and reorganize therapeutic strategies for timely management of patients with COVID-19 related pulmonary syndrome.Processing of radiographic and computed tomography images by means of artificial intelligence techniques can facilitate triage of patients.Modified and newer therapeutic strategies for patients with bronchogenic carcinoma have been adopted by oncologists around the world for providing uncompromised care within the accepted standards and new guidelines.

Intra-abdominal ectopic bronchogenic cyst with a mucinous neoplasm harboring a GNAS mutation: A case report

BACKGROUND Bronchogenic cysts are congenital cysts caused by abnormal sprouting from the ventral foregut during fetal life.They usually occur in the mediastinum or lung,but there are very rare cases of ectopic bronchogenic cysts that develop in the abdominal cavity.A unique intra-abdominal ectopic bronchogenic cyst with a mucinous neoplasm that was producing carcinoembryonic antigen(CEA),harboring a GNAS mutation,is reported.The present case may contribute to clarifying the mechanism of tumorigenesis and malignant transformation of ectopic bronchogenic cysts.CASE SUMMARY In 2007,a man in his 50s was incidentally found to have an intra-abdominal cystic mass,8 cm in diameter.Surgical resection was recommended,but he preferred to remain under observation.In 2020,his serum CEA level increased to 26.7 ng/mL,and abdominal computed tomography showed a 15 cm×12 cm,multifocal,cystic mass located predominantly on the lesser curvature of the stomach.Since malignancy could not be ruled out,he finally underwent surgical resection.Histologically,the cystic wall was lined by ciliated columnar epithelium,accompanied by bronchial gland-like tissue,bronchial cartilage,and smooth muscle.Part of the cyst consisted of atypical columnar epithelium with an MIB-1 index of 5%and positive for CEA.Moreover,a GNAS mutation(p.R201C)was detected in the atypical epithelium,leading to a diagnosis of an ectopic bronchogenic cyst with a low-grade mucinous neoplasm.The patient is currently undergoing outpatient follow-up without recurrence.CONCLUSION An extremely rare case of an abdominal bronchogenic cyst with a low-grade mucinous neoplasm harboring a GNAS mutation was reported.

Bronchogenic Cyst in a 23-Month-Old Infant at the University Hospital of Brazzaville

The bronchogenic cyst, a congenital pulmonary malformation of often late revelation is rare. Its clinical manifestation, depending on the size of the cyst and its location, is dominated by respiratory symptoms. We report a case of a bronchogenic cyst in a 23-month-old infant treated with salbutamol combined with corticosteroid therapy for a third episode of breathing difficulty and wheezing. A chest X-ray and CT scan guided the diagnosis. Histological confirmation was made on an operative specimen after removal of the cyst. The immediate and mid-term outcome was good.

Surgical results and prognosis of patients with primary bronchogenic carcinoma aged less than 30 years

Objective To investigate and analyze the clinical and pathological features of surgical treatment for primary bronchogenic carcinoma in adolescent patients. Methods A retrospective review is presented of patients less than 30 years with surgical treatment of bronchogenic

DETECTION OF HUMAN PAPILLOMAVIRUS TYPES 16, 18 DNA RELATED SEQUENCES IN BRONCHOGENIC CARCINOMA BY POLYMERASE CHAIN REACTION

In studying the relationship between human papillomavirus (HPV) and bronchogenic carcinoma, 'high-risk' HPV 16, 18 DNA sequences were detected in samples from 50 lung cancer patients, 18 patients with benign pulmonary diseases and 4 fetal lung tissues by polymerase chain reaction (PCR) and dot-blot hybridization with biotin-labelled probes. The results showed that HPV 16, 18 DNA related sequences were found in 32% of lung cancer specimens, with 10 cases of HPV 16, 5 cases of HPV 18 and 1 case of both types. 48.15% (13 / 27) of squamous cell carcinomas were shown to be positive for HPV 16, 18 DNA. In addition, two adenocarcinomas and one small cell carcinoma were positive for HPV 16 DNA. No specimens from benign diseases tissues and fetal lung tissues showed positive results. These results suggest that primary bronchogenic carcinoma is related to HPV infection.

Cutaneous bronchogenic cyst in the left scapular region of a boy

Background:Scapular bronchogenic cyst(SBC)is rare.Methods:A sinus on a boy's left scapula was excised.Results:Histopathological analysis showed the epithelium with scattered PAS-positive goblet cells was positive for CEA and CK7.Conclusion:SBC should be suspected of a superfi cial scapular skin lesion in children.

颈部支气管源性囊肿

支气管囊肿是一类发育异常性疾病,常发生在纵隔内,位于颈部的支气管囊肿非常罕见。现将我院1996～2006年诊治3例颈部支气管源性囊肿患者的临床资料总结分析如下。

Risk prediction models for lung cancer:Perspectives and dissemination

Objective: The objective was to systematically assess lung cancer risk prediction models by critical evaluation of methodology, transparency and validation in order to provide a direction for future model development.Methods: Electronic searches(including PubMed, EMbase, the Cochrane Library, Web of Science, the China National Knowledge Infrastructure, Wanfang, the Chinese BioMedical Literature Database, and other official cancer websites) were completed with English and Chinese databases until April 30 th, 2018. Main reported sources were input data, assumptions and sensitivity analysis. Model validation was based on statements in the publications regarding internal validation, external validation and/or cross-validation.Results: Twenty-two studies(containing 11 multiple-use and 11 single-use models) were included. Original models were developed between 2003 and 2016. Most of these were from the United States. Multivariate logistic regression was widely used to identify a model. The minimum area under the curve for each model was 0.57 and the largest was 0.87. The smallest C statistic was 0.59 and the largest 0.85. Six studies were validated by external validation and three were cross-validated. In total, 2 models had a high risk of bias, 6 models reported the most used variables were age and smoking duration, and 5 models included family history of lung cancer.Conclusions: The prediction accuracy of the models was high overall, indicating that it is feasible to use models for high-risk population prediction. However, the process of model development and reporting is not optimal with a high risk of bias. This risk affects prediction accuracy, influencing the promotion and further development of the model. In view of this, model developers need to be more attentive to bias risk control and validity verification in the development of models.