Giant intracardiac blood cyst of the mitral valve in a pediatric patient: A case report

Intracardiac blood cysts are rare congenital malformations most commonly located in the endocardium of semilunar or atrioventricular valves. They are predominantly seen in infants, especially below 2 months of age, and disappear spontaneously in the first 6 months of life making the detection of blood cysts a rare finding in the adult population. Although most patients are asymptomatic, they may occasionally present with obstruction, valvular dysfunction, or embolism. Herein, we present a 2.5-year-old female patient, who was successfully treated with surgical excision of an intracardiac blood cyst causing mild-to-moderate mitral regurgitation and obstruction.     

Esophageal bronchogenic cyst: a rare entity

BACKGROUND/AIMS: Bronchogenic cysts are congenital lesions of foregut origin, usually found in intrapulmonary or mediastinal locations. However, an esophageal bronchogenic cyst is an uncommon occurrence. The definitive diagnosis is based on histological findings after extirpation of the cyst. Surgical excision of bronchogenic cysts is considered appropriate because of the high complication rates of subsequent infection, rupture, hemorrhage, and malignant degeneration if left untreated. RESULTS: A 42-year-old man presented with a two-year history of progressive dysphagia. An esophageal bronchogenic cyst was evidenced by esophagography, Computed tomography, magnetic resonance imaging, and endoscopic ultrasound, followed by confirmation with surgical exploration. CONCLUSION: Esophageal bronchogenic cysts should be included in the differential diagnosis of a mediastinal tumor, especially when the tumor is within or near the tracheobronchial tube, even though it is a rare condition.     

Bronchogenic cyst invading right atrium in a 5-year-old

Primary bronchogenic cysts of cardiac origin or extension are rare. We report here on a 5-year-old girl with a bronchogenic cyst with a diameter of 5.0 x 4.5 x 4.5 cm extending to the right atrial wall. Tumor enucleation and resection of the cyst together with the invaded right atrial wall was performed through a right posterolateral thoracotomy and an opening in the lateral pericardium. Resection of intrapericardial bronchogenic cysts is possible, although extensive invasion of cardiac structures may necessitate the use of cardiopulmonary bypass through a sternotomy.     

Intramural esophageal bronchogenic cysts

Bronchogenic cysts are most frequently located in the middle mediastinum near the carina. Esophageal bronchogenic cysts are extremely rare. An intramural esophageal bronchogenic cyst was successfully resected from a 51-year-old man.     

Intramural esophageal bronchogenic cysts: a review of the literature

Bronchogenic cysts are rare congenital cystic lesions mostly located in the middle and superior mediastinum. Esophageal bronchogenic cysts are extremely rare. We review here 23 cases reported in English in the literature to date of intramural esophageal bronchogenic cyst and their features, including our patient. Although they are extremely rare, intramural esophageal bronchogenic cysts should be kept in mind in the differential diagnosis of benign esophageal lesions. With accurate diagnosis and treatment the prognosis is excellent and serious complications may be prevented.     

Multiple Bronchogenic Cysts of the Esophagus

Esophageal location of bronchogenic cysts is rare especially if two cysts are present. We report such a case in a girl 17 years old who had several intramural esophageal smooth defects which looked like multiple leiomyomatosis of the esophagus. At surgery there were two bronchogenic cysts arising in the wall of the esophagus and lying on each side of the azygos arch.
Bronchogenic cysts of the esophagus are rare, especially if two cysts are present.     

先天性支气管囊肿的临床及病理分析

目的 探讨先天性支气管囊肿的临床及病理特点。方法 回顾性分析我院1997年1月至2002年1月经手术切除病理证实的30例先天性支气管囊肿患的临床及病理资料。结果 根据x线胸片、胸部CT检查结果,本组患病灶肺内型23例、纵隔型5例、异位型2例。其中液囊肿18例、气囊肿7例、多发肺囊肿5例。肺内型多以并发感染就诊,其中19例表现为咳嗽、咳痰,2例伴发热,11例表现为咯血或痰中带血,11例有不同程度的胸痛;CT特征为囊腔大、周围软组织少的“块中囊”,或薄壁的空腔、多发性蜂窝状、囊腔状环行透光影。纵隔型2例于体检时偶然发现,2例因囊肿压迫气管而出现胸闷、呼吸困难,1例压迫食管而出现吞咽梗塞感;CT特点为边界清楚、密度一致的孤立性圆形或卵圆形阴影,与周围器官组织相互挤压变形。异位型2例均于体表扪及囊性包块就诊。病理检查：镜下均可见假复层纤毛柱状上皮、腺体、软骨、弹力纤维和少量平滑肌。结论 先天性支气管囊肿以肺内型为多,临床表现主要为咳嗽、咳痰及咯血,cT检查以块中囊为其特征性表现;组织病理学检查均具备呼吸上皮、腺体、软骨和平滑肌。手术切除是治疗的最佳方案。     

Two atypical cases of esophagogastric junctional bronchogenic cyst: one case included squamous cell carcinoma

Bronchogenic cysts are congenital lesions that are derived from the lung bud and are often found in the thoracic cavity, and intra-abdominal bronchogenic cysts are really rare. They are associated with respiratory symptoms and typically require surgical resection. Herein, we describe two cases with esophagogastric junctional bronchogenic cysts. Our first case was a man in his 30s who had a submucosal tumor at esophagogastric junction, which required laparoscopic enucleation. The second case was a woman in her 50s who underwent laparoscopy-assisted proximal gastrectomy. The resected tumor was diagnosed as a bronchogenic cyst, with squamous cell carcinoma at the mucosal surface. Bronchogenic cysts are occasionally associated with complications and malignancies, and thus, preventive and diagnostic resection is recommended.     

Subdiaphragmatic bronchogenic cyst of the esophagus masquerading as a metastatic lymph node of coexisting advanced gastric cancer

Esophageal bronchogenic cysts are rare bronchopulmonary foregut malformations, and those located in the abdominal cavity are particularly rare. Esophageal cysts are typically found incidentally; an exact preoperative diagnosis of bronchogenic cyst is difficult, and surgical resection is generally recommended. Here, we report a case in which a subdiaphragmatic bronchogenic cyst of the esophagus coexisted with advanced gastric cancer. A 44-year-old man was referred for the treatment of gastric cancer. A preoperative examination revealed a mass on the right side of the esophagogastric junction that was preoperatively diagnosed as a metastatic lymph node. Intraoperative exploration revealed that the mass had protruded from the abdominal esophageal wall, and was diagnosed as a cyst originating from the subdiaphragmatic esophagus. The cyst was completely resected with the whole stomach and abdominal esophagus. The histopathological findings of the cyst were specific for a bronchogenic origin. The patient has not shown any signs of disease recurrence.     

Unusual case of stridor and wheeze in an infant: tracheal bronchogenic cyst

Bronchogenic cysts are congenital anomalies that represent aberrant development of the foregut. Bronchogenic cysts in the mediastinum have been documented in both children and adults, but only one case of tracheal bronchogenic cyst in an infant was found in the literature. We report on a case of an infant with wheeze, stridor, and retractions, caused by a midtracheal bronchogenic cyst. This entity, with its unusual location, should be considered in the differential diagnosis of respiratory distress, cyanotic spells, wheezing, and stridor in infants.     

Right ventricular bronchogenic cyst

We report an exceedingly rare case of primary bronchogenic cyst in the outflow tract of the right ventricle in a 48-year-old woman. In our review of the world literature, we found only 1 other report of an intracardiac bronchogenic cyst. Our patient's only symptom was mild dyspnea not associated with physical exertion, and the cyst was resected successfully. We report clinical aspects of the case, diagnostic methods, surgical management, and histopathologic findings.     

A rare presentation of a bronchogenic cyst: presternal, subcutaneous and 42-year-old man

Bronchogenic cysts are generally detected shortly after birth or in early childhood. Most lesions are found in the mediastinum, along the tracheobronchial tree or in the lung parenchyma. Cutaneous or subcutaneous bronchogenic cysts are rarely reported. Our patient was the second case in the English literature who had a cyst over the manubrium sterni in adult life. Surgical total excision is the definitive treatment of extrathoracic bronchogenic cysts, needle aspiration management should not be tried because of association with malignant lesions as mucoepidermoid carcinoma and malign melanoma have been reported to arise from them.     

Superior vena cava syndrome caused by bronchogenic cyst.

A patient with superior vena cava syndrome due to an infected benign mediastinal bronchogenic cyst is reported. Although bronchogenic cyst is a rare cause of the superior vena cava syndrome, it should be considered because it is a potentially treatable lesion. Patients with bronchogenic cysts should have elective surgery before major complication develop.     

Bronchogenic cyst

The clinical presentation of the bronchogenic cyst is variable, from respiratory distress at birth to late appearance of symptoms. In order to determine clinical features and treatments, we retrospectively studied the medical records and pathology reports of all patients with bronchogenic cysts (n = 22) referred to our surgical department from February 1985 through January 2002. They included 18 male and 4 female patients with an age range of 1 to 38 years (average, 16.4 years). There were 14 mediastinal, 2 hilar, and 6 intrapulmonary bronchogenic cysts. Symptoms were present in 18 of the 22 patients. Cough was the most common symptom (45%). Ten patients (45%) presented with complications: severe hemoptysis, pneumothorax and pleuritis, esophageal compression, infected cyst, and postobstructive pneumonia. In all patients, complete resection of the bronchogenic cyst was performed by thoracotomy A postoperative sequela occurred in only 1 patient, who had a persistent air leak. There were no late sequelae, nor was there a recurrence of the cyst. The follow-up period ranged from 8 months to 12 years (mean, 5.2 years). Because a confident preoperative diagnosis is not always possible and because complications are common, we recommend surgical resection of all suspected bronchogenic cysts in operable candidates.     

Incidental Left Atrial Blood Cyst in a Patient Undergoing Transcatheter Aortic Valve Replacement

Blood cysts of the heart are benign cardiovascular tumors found incidentally in approximately 50% of infants who undergo autopsy at less than 2 months of age. These congenital cysts, frequently present on the atrioventricular valves of infants, are exceedingly rare in adults. Nonetheless, in adults, cardiac blood cysts have been found on the mitral valve, papillary muscles, right atrium, right ventricle, left ventricle, and aortic, pulmonic, and tricuspid valves. Reported complications include left ventricular outflow obstruction, occlusion of the coronary arteries, valvular stenosis or regurgitation, and embolic stroke.In high-risk patients with severe aortic stenosis, transcatheter aortic valve replacement has emerged as an alternative to surgical replacement. Transesophageal echocardiography plays a fundamental role in evaluating the feasibility of intraprocedural transcatheter aortic valve replacement, in measuring aortic annular size, in guiding placement of the prosthetic device, and in looking for possible complications. The embolic risk of rapid pacing and transcatheter aortic valve replacement in a patient with an intracardiac blood cyst is unknown, and such a case has not, to our knowledge, been reported heretofore. We present the case of a 78-year-old woman with severe aortic stenosis, in whom a blood cyst was incidentally found in the left atrium upon transesophageal echocardiography. She underwent successful transcatheter aortic valve replacement without embolic complication.     

Quality of Life and Psychosocial Aspects of Cough

Bronchogenic cysts are uncommon congenital anomalies of foregut origin and usually located within the mediastinum and the lung. A retrospective study of 33 thoracic bronchogenic cysts was undertaken to detail their clinicopathologic and radiologic features. There were 18 male and 15 female patients between 12 and 77 years of age with a mean age of 41 years. Thirty-one patients (94%) were symptomatic at the time of diagnosis and the chief complaint was chest pain (48.5%). Most of the cysts presented as homogeneous water-density shadows on standard chest radiographs. The location was intrapulmonary in 25 cases and mediastinal in 8 cases. Based on radiologic investigations, preoperative diagnosis of bronchogenic cyst was made in only 11 cases (33.34%). Surgical excision of the cyst was approached via thoracotomy in 32 cases and thoracoscopy in one case. Total excision of the cyst was performed in 31 cases and subtotal resection in 2 cases. Pathologic findings were consistent with bronchogenic cyst in all cases. During the follow-up period, which ranged between 1 month and 51 months, all patients were symptom-free with no evidence of recurrence. Complete surgical resection is recommended for all bronchogenic cysts to establish diagnosis, alleviate symptoms, and prevent complications.     

A paraesophageal bronchogenic cyst with esophageal communication

Paraesophageal bronchogenic cysts are a rare developmental anomaly of the upper digestive tract. Although often asymptomatic, their growth can cause severe symptoms and complications because of the location. The diagnosis is difficult and is mostly by histopathologic findings after extirpation of the cyst. The authors present a case of a paraesophageal bronchogenic cyst, of typical histologic structure (ciliated epithelium and hyaline cartilage) connected with the esophageal lumen by a narrow canal composed of stratified squamous epithelium. According to the available literature, only three cases of bronchogenic paraesophageal cysts with esophageal communication have been reported.     

Clinical electrophysiology of atrioventricular block

The diagnosis of various forms of atrioventricular conduction disorder is considered in the light of intracardiac recording techniques. Criteria for the topographic diagnosis of AV block based on intracardiac recordings are described in this article.     

Bronchogenic cyst in the abdomen--a case report

A man in his thirties with epigastric pain was referred to our hospital for detailed examinations. Abdominal computed tomography showed an abdominal cystic lesion with a longest dimension of 7 cm, located behind the stomach. Endoscopic ultrasonography through the stomach showed a cystic lesion and the wall of the lesion revealed continuity to the proper muscle layer of the gastric wall. Therefore, gastric duplication was suspected and the cystic lesion was resected because of the possibility of malignancy and also for a definitive diagnosis. The cystic lesion consisted of columnar ciliated epithelium, seromucous glands, smooth muscle and cartilage and was diagnosed as a bronchogenic cyst. Bronchogenic cysts are sometimes encountered in the thoracic or mediastinal area, but abdominal bronchogenic cysts, such as the present case, are extremely rare.     

High prevalence of estrogen and progesterone receptor expression in mediastinal cysts situated in the posterior mediastinum

BACKGROUND: To identify and estimate the prevalence of mediastinal cysts lined by the epithelium expressing steroid receptors. METHODS: We retrieved 19 mediastinal cysts from our pathology files from 1996 to 2004, and examined estrogen receptor (ER) and progesterone receptor (PR) expressions in the cysts. RESULTS: Three paravertebral cysts, all in women, one bronchogenic cyst in a woman, nine thymic cysts, and six pericardial cysts were found in the pathology files. Paravertebral cysts were situated in the posterior mediastinum and were attached either to the left or the right of the vertebral column. All cysts were radiologically diagnosed before surgery as neurogenic tumors. They were excised by video-assisted thoracoscopic surgery. The epithelial lining of the cyst in all three cases was strongly positive for both ER and PR. A thymic cyst in one woman was weakly positive only for the ER. In all other cases, the lining was entirely negative for both ER and PR. CONCLUSIONS: Posterior mediastinal paravertebral cysts characteristically express ER and PR. They should be recognized as a distinct type of mediastinal cyst because they are biologically different from bronchogenic cysts, seem not to be infrequent, and sometimes are misdiagnosed as a neurogenic tumor.