Bronchogenic cyst

支气管囊肿
  • 文章类型: Case Reports
    背景:支气管源性囊肿是一种罕见的发育异常,属于先天性肠源性囊肿。它们来自肺芽,并在出生时存在。胚胎前肠是它们的起源。通常,它们位于胸腔内,特别是在胸腔的腔内纵隔或滞留在肺实质中,被认为是一种肺芽畸形。
    方法:一名49岁男性患者因体格检查中发现腹膜后肿块而入院。入院前两周,患者接受了体格检查和常规实验室检查,显示腹膜后区域有一个占位性肿块。患者未报告任何症状(如腹痛,胀气,恶心,呕吐,高烧,或发冷)。计算机断层扫描(CT)显示腹膜后占位性病变,增强最小,CT值为约36Hounsfield单位。病变未从胰体边界划定,与腹膜后局部密切相关。
    结论:经过一系列测试,确认了一个腹部肿块,提示实施腹腔镜腹膜后肿块切除术。在调查过程中,在胰腺的上后部区域发现了一个8cm×7cm的囊性圆形肿块,有明显的分界。随后,对肿块进行了完全切除.术后病理检查发现囊性肿块,其特征是内壁光滑。发现囊性肿块含有白色,其胶囊内的粘性液体。
    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.
    METHODS: 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 space-occupying 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.
    CONCLUSIONS: 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.
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  • 文章类型: Case Reports
    背景:胃支气管囊肿(BCs)是胚胎期呼吸系统发育异常引起的极其罕见的囊性肿块。胃支气管囊肿是1956年首次报道的罕见病变;截至2023年,PubMed在线数据库中只有33例病例。BCs通常在早期没有临床症状,影像学检查结果也缺乏特异性。因此,在组织病理学检查之前很难诊断。
    方法:一位34岁的呼吸窘迫患者出现在我们医院。内窥镜超声显示脾脏之间有消声肿块,左肾和胃底,具有高回声和软弹性成像纹理,大小约为6.5cm×4.0cm。此外,计算机断层扫描显示后胃和脾脏和左肾之间的高密度,内部密度均匀,有少量钙化。最大横截面约为10.1cm×6.1cm,囊肿的可能性很高。因为影像学检查结果没有提示恶性肿瘤,并且患者需要完全切除,她接受了剖腹手术。术中,发现该囊性病变位于眼底大曲率的后壁,大小约为8cm×6cm。最后,病理学家证实眼底囊肿是胃BC。病人恢复得很好,她胸闷的症状消失了,术后第6天取出腹腔引流管,术后第7天出院,随访6个月。随访期间无肿瘤复发及术后并发症。
    结论:这是一个有价值的报告,因为它描述了一个非常罕见的胃BC病例。此外,这是一个非常年轻的病人,胃里有一个大的BC。
    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.
    METHODS: 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.
    CONCLUSIONS: 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.
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  • 文章类型: Journal Article
    支气管囊肿是一种罕见的呼吸道囊性畸形。如果发生在妊娠早期,主要位于纵隔,如果发生在发育后期,则位于胸腔。然而,它们可以来自前肠的任何部位。他们表现出各种临床和放射学表现,代表诊断挑战,特别是在有包虫病流行的地区。内窥镜引流已成为一种诊断和潜在的治疗选择,但由于感染的报道而变得复杂。手术切除仍然是护理标准,可以通过病理检查解决症状和明确诊断;微创方法,例如机器人和胸腔镜方法,有助于治疗。完全切除后,预后良好,基本无复发。
    从1975年到2022年,使用PubMed和GoogleScholar对可用的电子文献进行了审查,强调最近的系列。我们纳入了所有回顾性系列和病例报告。一位作者确定了这些研究,所有作者都对选择进行了审查,直到就纳入哪些研究达成共识。
    文献由相对较小的系列组成,混合在成人和儿童患者之间,共识仍然是,所有有症状的病变都应在可行的情况下通过微创方法切除。
    手术切除有症状的支气管囊肿仍然是金标准,保留内窥镜引流用于诊断或作为临床不稳定患者的临时措施。
    UNASSIGNED: 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.
    UNASSIGNED: 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.
    UNASSIGNED: 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.
    UNASSIGNED: 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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  • 文章类型: Review
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  • 文章类型: Review
    背景:淋巴细胞间质性肺炎(LIP)是一种罕见的良性淋巴增生性疾病,常与自身免疫性疾病相关。大多数LIP表现为多发支气管囊肿和弥漫性间质浸润。它的组织学特征是广泛的弥漫性肺间质淋巴细胞浸润,以及肺泡间隔的扩大和扩大。
    方法:一名49岁女性因发现肺结节超过2个月而入院。双肺的3D成像胸部计算机断层扫描(CT)检查显示右肺中叶,大小约为1.5cm×1.1cm的磨玻璃结节。
    方法:对右中肺结节行单孔胸腔镜楔形切除活检。病理表现为弥漫性淋巴细胞浸润,有不同数量的小淋巴细胞,浆细胞,巨噬细胞和组织细胞浸润肺泡间隔,扩大和扩大的肺泡间隔,和分散的淋巴滤泡。免疫组织化学,卵泡区CD20阳性,滤泡间区CD3阳性。LIP被考虑。
    方法:对患者进行定期随访,不进行任何特殊治疗。
    结果:术后6个月胸部CT随访显示肺部无明显异常。
    结论:据我们所知,我们的病例可能是第二例报告的LIP患者在胸部CT上表现为磨玻璃结节,推测磨玻璃结节可能是特发性LIP的早期表现。
    BACKGROUND: Lymphocytic interstitial pneumonia (LIP) is a rare benign lymphoproliferative disorder, often associated with autoimmune diseases. Most LIPs present with multiple bronchial cysts and diffuse interstitial infiltration. It is histologically characterized by widespread diffuse lymphocytic infiltration of the pulmonary interstitium, and the enlargement and widening of the alveolar septum.
    METHODS: A 49-year-old woman was admitted to hospital for finding pulmonary nodules for more than 2 months. 3D imaging chest computed tomography (CT) examination of both lungs showed that there was a middle lobe of the right lung with a size of about 1.5 cm × 1.1 cm ground-glass nodules.
    METHODS: A single operating port thoracoscopic wedge resection biopsy of a right middle lung nodule was performed. The pathology showed diffuse lymphocytic infiltration with varying numbers of small lymphocytes, plasma cells, macrophages and histiocytes infiltrating the alveolar septa, widened and enlarged alveolar septa, and scattered lymphoid follicles. Immunohistochemically, CD20 positive in follicular area, CD3 positive in interfollicular area. LIP was considered.
    METHODS: The patient was regularly followed without any specific treatment.
    RESULTS: Follow-up chest CT showed no significant abnormalities in the lungs 6 months after surgery.
    CONCLUSIONS: To the best of our knowledge, our case may be the second reported case of a patient with LIP presenting with a ground glass nodule on chest CT, and it is speculated that the ground glass nodule may be an early manifestation of idiopathic LIP.
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  • 文章类型: Case Reports
    支气管囊肿是一种罕见的起源于原始前肠的气管支气管芽的先天性畸形,尤其是在腹膜后区域.成人腹膜后支气管囊肿术前难以做出准确诊断。
    UNASSIGNED:我们介绍了3例类似成人肾上腺肿瘤的腹膜后支气管囊肿。三例无症状,都在左边.在对比增强的计算机断层扫描中,囊肿壁没有显着增强。2例影像学表现为典型的多房囊和散在钙化,而另一个显示单眼囊,无钙化,血清糖类抗原(CA)19-9和CA24-2升高。3例患者行腹膜后腹腔镜手术。组织病理学检查证实了腹膜后支气管囊肿的诊断。随访期间3例患者均无复发。
    未经证实:腹膜后支气管囊肿大多无症状。可以在计算机断层扫描中发现可变结果的成年人中发现。它可能被忽略和误诊为肾上腺肿瘤。
    未经证实:CA19-9和CA24-2的检测可以帮助诊断腹膜后支气管囊肿。建议腹膜后腹腔镜手术治疗腹膜后支气管囊肿,预后良好。
    Bronchogenic cyst is a rare congenital malformation of the tracheobronchial bud originating from the primitive foregut, especially in the retroperitoneal region. Retroperitoneal bronchogenic cysts in adults are difficult to make an accurate diagnosis preoperatively.
    UNASSIGNED: We present three cases of retroperitoneal bronchogenic cysts resembling adrenal tumors in adults. Three cases were asymptomatic, and all were located on the left side. There was no significant enhancement of the cyst walls on contrast-enhanced computed tomography. Two cases presented with typical multilocular sacs and scattered calcification on radiology, whereas the other one showed unilocular sacs, without calcification, and elevation of serum carbohydrate antigen (CA) 19-9 and CA 24-2. Three cases underwent retroperitoneal laparoscopic surgeries. Histopathologic examination confirmed the diagnosis of retroperitoneal bronchogenic cysts. There was no recurrence of the three cases during follow-up.
    UNASSIGNED: A retroperitoneal bronchogenic cyst is mostly asymptomatic. It can be found in adults with variable findings in computed tomography. It can be likely ignored and misdiagnosed as an adrenal tumor.
    UNASSIGNED: The tests of CA 19-9 and CA 24-2 could help diagnose retroperitoneal bronchogenic cysts. Retroperitoneal laparoscopic surgery is recommended for the treatment of retroperitoneal bronchogenic cysts with a favorable prognosis.
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  • 文章类型: Case Reports
    支气管囊肿是先天性发育不良的良性病变。尽管这种类型的囊肿在腹膜后很少发生,在支气管囊肿中,流体水平的存在更为罕见。因此,由于缺乏特定影像学表现的通用指南,很容易误诊。本报告描述了患有支气管囊肿并具有液体水平的患者的情况,同时还进行了简短的文献综述,以总结先前关于这种情况的报道的发现。一名48岁的男性患者出现严重的下背部疼痛,没有任何明显的原因。CT扫描显示在T12-L2区域的左前方有一个约3x4x6厘米的低密度囊性肿块,起源于横隔膜的左脚。MRI显示囊肿中有液体水平。进行前胸腰椎手术以完全切除肿块。在手术过程中,经病理证实,囊肿起源于膈肌左足,经病理分析诊断为支气管囊肿。术后患者症状改善,3年随访期间未见囊肿复发。腹膜后支气管囊肿中很少有液体水平的存在,特别是在腹主动脉和椎旁区域,很容易误诊.它可能与蛋白质有关,囊肿中出血和含钙粘液沉积。在本研究中,本文报道了1例罕见的支气管囊肿患者出现液-液水平的病例,并提供了文献综述.
    Bronchogenic cyst is a benign lesion with congenital dysplasia. Although the occurrence of this type of cyst is rare in the retroperitoneum, the presence of fluid-fluid levels is an even rarer phenomenon in bronchogenic cysts. Therefore, it can be easily misdiagnosed due to the lack of a universal guideline of specific imaging manifestations. The present report describes the case of a patient with a bronchogenic cyst with fluid-fluid levels whilst also performing a brief literature review to summarize the findings of previous reports on this condition. A 48-year-old male individual presented with severe lower back pain without any obvious causes. A CT scan revealed a low-density cystic mass of ~3x4x6 cm in the left front of the T12-L2 area, which originated from the left crus of the diaphragm. MRI revealed a fluid-fluid level in the cyst. Anterior thoracolumbar surgery was performed to completely resect the mass. During the surgery, it was confirmed that the cyst originated from the left crus of the diaphragm and the lesion was diagnosed to be a bronchogenic cyst by pathological analysis. The patient\'s symptoms improved after the surgery and no recurrence of the cyst was observed during the 3-year follow-up period. The presence of a fluid-fluid level in a retroperitoneal bronchogenic cyst is rare, particularly in the abdominal aorta and paravertebral regions, rendering it easily misdiagnosed. It may be associated with protein, hemorrhage and calcium-containing mucus deposition in the cysts. In the present study, a rare case of fluid-fluid level in bronchogenic cyst was reported and a literature review was provided.
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  • 文章类型: Journal Article
    支气管囊肿是由异常前肠出芽引起的先天性畸形。它们主要发生在胸部,膈下病例不常见。这里,我们介绍了2012年至2021年在中国一家机构经组织病理学诊断为膈下支气管囊肿的19例患者。还通过使用与“支气管囊肿”和“膈下”相关的关键词搜索PubMed数据库进行了文献综述,“产生107例。一起来看,126例患者的中位年龄为41.0岁(四分位距,30.0-51.0岁),其中62人为男性(49.2%)。囊肿最常见于左肾上腺区(36.2%),其次是胰腺区域(11.5%)和胃card门/胃的较小曲率(9.2%)。除两名患者外,所有患者均接受手术以明确诊断,症状缓解,和(或)恶性肿瘤预防。大部分患者恢复快,术后1周内出院,手术并发症很少见。预后总体良好,因为在长达77个月的随访期间没有报告复发.
    Bronchogenic cysts are congenital malformations caused by aberrant foregut budding. They major occur in the thorax, with subdiaphragmatic cases being uncommon. Here, we present a series of 19 patients diagnosed with subdiaphragmatic bronchogenic cysts histopathologically at a single institution in China from 2012 to 2021. A literature review was also conducted by searching the PubMed database using keywords related to \"bronchogenic cysts\" and \"subdiaphragmatic,\" yielding 107 cases. Taken together, the 126 cases had a median age of 41.0 years (interquartile range, 30.0-51.0 years) and 62 of them were male (49.2%). The cysts were most commonly detected in the left adrenal region (36.2%), followed by the pancreatic region (11.5%) and gastric cardia/lesser curvature of the stomach (9.2%). All patients except two underwent surgery for a definite diagnosis, symptom alleviation, and (or) malignancy prevention. Most patients recovered fast and were discharged from the hospital within 1 week after surgery, and the surgical complications were infrequent. The prognosis was generally favorable, as no recurrence was reported during the follow-up as long as 77 months.
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  • 文章类型: Case Reports
    背景:腹膜后支气管囊肿(RBC)是一种极其罕见的发育异常。大多数是良性肿瘤,但恶性转化是可能的。由于它们的解剖位置,在放射学评估中,红细胞很容易被误诊为肾上腺或胰腺实体瘤。这里,我们报告一例红细胞,回顾文献,并总结一些重要特征。
    方法:一名49岁女性在体格检查中偶然发现患有腹膜后肿瘤。增强计算机断层扫描和实验室评估,包括血常规检查,血液生物化学,24小时尿17酮,17羟基,肾上腺皮质激素,血清钾浓度,血清淀粉酶,脂肪酶,和上皮肿瘤标志物,显示出中等密度,54mm×40mm肿块,左肾上腺附近边界清晰。血液和尿液值没有异常。因为患者有高血压病史,肿块的位置靠近肾上腺,它最初被诊断为左肾上腺肿瘤,并通过后腹腔镜手术切除。然而,手术后病理检查证实为支气管囊肿。
    结论:有症状的RBC患者可以优先考虑腹膜后腹腔镜手术。对选定的患者进行保守治疗是可行的。
    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.
    METHODS: 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.
    CONCLUSIONS: Retroperitoneal laparoscopic surgery can be prioritized for symptomatic RBC patients. Conservative treatment is feasible for selected patients.
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