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KMID : 1038120210540050767
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Clinical Endoscopy
2021 Volume.54 No. 5 p.767 ~ p.770
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Endoscopic Ultrasound Through-the-Needle Biopsy for the Diagnosis of an Abdominal Bronchogenic Cyst
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Cassiani Jessica
Crino Stefano Francesco
Manfrin Erminia
Rivelli Matteo
Gabbrielli Armando
Guglielmi Alfredo
Pedrazzani Corrado
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Abstract
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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.
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KEYWORD
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Bronchogenic cyst, Endoscopic ultrasound-guided fine-needle aspiration, Endoscopic ultrasound-guided through-the-needle biopsy, Laparoscopy, Pancreatic cyst
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