Bronchogenic cyst

支气管囊肿
  • 文章类型: English Abstract
    这项研究的目的是探讨产前磁共振成像(MRI)在评估胎儿先天性囊性肺病中的实用价值,评估病变的相对大小和肺发育状况,并尝试在后处理中利用MRI的强度来获得病变大小和肺部发育状况的评估指标,可以预测这些胎儿出生后可能面临的预后。我们回顾性收集并分析了诊断为先天性囊性肺病的胎儿数据。这些胎儿的产前超声检查导致诊断他们怀疑患有先天性囊性肺病,并且随后的产前MRI证实了诊断。对胎儿进行随访以跟踪其出生时的状况(产后呼吸窘迫,机械通气,等。),胎儿是否接受了手术治疗,以及手术治疗后胎儿的恢复。随访胎儿的恢复情况,探讨产前MRI检查评估胎儿先天性肺囊性疾病的可行性,初步探讨产前MRI对先天性肺囊性疾病胎儿预后的预测价值。
    MRI胎儿图像收集自2018年5月至2023年3月在四川大学华西第二医院就诊的孕妇,通过产前超声和随后的MRI诊断为胎儿先天性肺囊性疾病。对先天性囊性肺病胎儿MRI图像进行后处理,获得胎儿肺部病变体积,胎儿受累的肺容积,健康的肺容量,和胎儿头围测量。肺和肝脏的信号强度,病变体积/受影响的肺体积,病变体积/总肺体积,囊性体积比(CVR),并测量双侧肺-肝信号强度比。结合胎儿出生后6个月的随访结果,进一步分析MRI后处理采集指标对先天性囊性肺病胎儿预后评估的可行性和价值。采用Logistic回归模型对产妇年龄、MRI时的孕周,CVR,和双侧肺-肝信号强度比,并评估这些指标是否与不良预后相关。受试者工作特征(ROC)曲线用于评估单独通过MRI计算获得的参数以及与预测出生后不良预后的多种指标相结合的参数的价值。
    我们收集了2018年5月至2023年3月间通过胎儿MRI诊断为先天性囊性肺病的胎儿共67例,并排除了6例受影响肺部无正常肺组织的病例,11例胎儿诱导,3例失孕。最后,纳入47例先天性囊性肺病胎儿,其中30例预后良好,17例预后不良。预后良好组与预后不良组胎儿患侧和健侧肺、肝的信号强度比值差异有统计学意义(P<0.05),健康侧肺和肝脏的信号强度比高于患侧肺和肝脏的信号强度比。进一步分析表明,CVR(比值比[OR]=1.058,95%置信区间[CI]:1.014-1.104),患侧和健康侧的肺-肝信号强度比之间的差异(OR=0.814,95%CI:0.700-0.947)与先天性囊性肺病胎儿的出生预后不良相关。此外,ROC曲线分析显示,联合应用病变体积/受累肺体积和观察到的受累肺与健康肺和肝脏之间信号强度比值的差异,比单参数判断更准确地预测先天性囊性肺病患儿的预后。曲线下面积为0.988,截止值为0.33,对应灵敏度为100%,特异性为93.3%,95%CI为0.966-1.000。
    基于先天性囊性肺病胎儿的MRI,我们获得了病变体积的信息,病变体积/受影响的肺体积,病变体积/总肺体积,CVR,和双侧肺-肝信号强度比值差异,所有这些都在预测先天性囊性肺病胎儿的不良预后方面显示出一定的临床价值。此外,在组合指数中,病变体积/受累肺体积和双侧肺-肝信号强度比差异是先天性囊性肺病胎儿预后不良的更有效预测因子。在预测先天性囊性肺病胎儿的不良预后方面有较好的疗效。这为进一步评估先天性囊性肺病胎儿的肺发育提供了一种新的有效的预测方法。有助于提高对先天性囊性肺病胎儿预后的评估和预测。
    UNASSIGNED: The aim of this study is to explore the practical value of prenatal magnetic resonance imaging (MRI) in the assessment of congenital cystic lung disease in fetuses, to evaluate the relative size of the lesion and the status of lung development, and to make an attempt at utilizing the strength of MRI in post-processing to obtain assessment indicators of the size of the lesion and the status of lung development, with which predictions can be made for the prognosis that these fetuses may face after birth. We retrospectively collected and analyzed the data of fetuses diagnosed with congenital cystic lung disease. Prenatal ultrasound examination of these fetuses led to the diagnosis that they were suspected of having congenital cystic lung disease and the diagnosis was confirmed by subsequent prenatal MRI. The fetuses were followed up to track their condition at birth (postnatal respiratory distress, mechanical ventilation, etc.), whether the fetuses underwent surgical treatment, and the recovery of the fetuses after surgical treatment. The recovery of the fetuses was followed up to explore the feasibility of prenatal MRI examination to assess fetal congenital pulmonary cystic disease, and to preliminarily explore the predictive value of prenatal MRI for the prognosis of fetuses with congenital pulmonary cystic disease.
    UNASSIGNED: MRI fetal images were collected from pregnant women who attended the West China Second University Hospital of Sichuan University between May 2018 and March 2023 and who were diagnosed with fetal congenital pulmonary cystic disease by prenatal ultrasound and subsequent MRI. Fetal MRI images of congenital cystic lung disease were post-processed to obtain the fetal lung lesion volume, the fetal affected lung volume, the healthy lung volume, and the fetal head circumference measurements. The signal intensity of both lungs and livers, the lesion volume/the affected lung volume, the lesion volume/total lung volume, the cystic volume ratio (CVR), and the bilateral lung-liver signal intensity ratio were measured. The feasibility and value of MRI post-processing acquisition indexes for evaluating the prognosis of fetuses with congenital cystic lung disease were further analyzed by combining the follow-up results obtained 6 months after the birth of the fetus. Logistic regression models were used to quantify the differences in maternal age, gestational week at the time of MRI, CVR, and bilateral lung-to-liver signal intensity ratio, and to assess whether these metrics correlate with poor prognosis. Receiver operating characteristic (ROC) curves were used to assess the value of the parameters obtained by MRI calculations alone and in combination with multiple metrics for predicting poor prognosis after birth.
    UNASSIGNED: We collected a total of 67 cases of fetuses diagnosed with congenital cystic lung disease by fetal MRI between May 2018 and March 2023, and excluded 6 cases with no normal lung tissue in the affected lungs, 11 cases of fetal induction, and 3 cases of loss of pregnancy. In the end, 47 cases of fetuses with congenital cystic lung disease were included, of which 30 cases had a good prognosis and 17 cases had a poor prognosis. The difference in the difference between the signal intensity ratios of the affected and healthy sides of the lungs and livers of the fetuses in the good prognosis group and that in the poor prognosis group was statistically significant (P<0.05), and the signal intensity ratio of the healthy side of the lungs and livers was higher than the signal intensity ratio of the affected side of the lungs and livers. Further analysis showed that CVR (odds ratio [OR]=1.058, 95% confidence interval [CI]: 1.014-1.104), and the difference between the lung-to-liver signal intensity ratios of the affected and healthy sides (OR=0.814, 95% CI: 0.700-0.947) were correlated with poor prognosis of birth in fetuses with congenital cystic lung disease. In addition, ROC curve analysis showed that the combined application of lesion volume/affected lung volume and the observed difference in the signal intensity ratio between the affected and healthy lungs and liver predicted the prognosis of children with congenital cystic lung disease more accurately than the single-parameter judgment did, with the area under the curve being 0.988, and the cut-off value being 0.33, which corresponded to a sensitivity of 100%, a specificity of 93.3%, and a 95% CI of 0.966-1.000.
    UNASSIGNED: Based on the MRI of fetuses with congenital cystic lung disease, we obtained information on lesion volume, lesion volume/affected lung volume, lesion volume/total lung volume, CVR, and bilateral lung-to-liver signal intensity ratio difference, all of which showing some clinical value in predicting the poor prognosis in fetuses with congenital cystic lung disease. Furthermore, among the combined indexes, the lesion volume/affected lung volume and bilateral lung-to-liver signal intensity ratio difference are more effective predictors for the poor prognosis of fetuses with congenital cystic lung disease, and show better efficacy in predicting the poor prognosis of fetuses with congenital cystic lung disease. This provides a new and effective predictive method for further assessment of pulmonary lung development in fetuses with congenital cystic lung disease, and helps improve the assessment and prediction of the prognosis of fetuses with congenital cystic lung disease.
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  • 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: Case Reports
    背景:尽管食管支气管囊肿是良性疾病,它们可能伴有严重的并发症,并有复发的可能性。因此,一旦确认,当排除禁忌症时,有必要治疗食管支气管囊肿。内镜治疗通常用于直径小、起源浅的病变,具有手术创伤小、风险小的优点,可以在一定程度上减轻患者的心理负担,帮助他们早日康复,降低医院费用。
    方法:病例1是我院收治的一名54岁的汉族男子,他抱怨过去6个月吞咽困难。病例2是一名41岁的汉族男子,在过去3个月内因胸部不适住院。内窥镜超声显示固有肌层引起的低回声囊性病变。使用双刀进行粘膜下隧道内窥镜切除术,在食管粘膜和肌肉层之间观察到囊性肿块。在定位囊肿时,在病变的口腔侧切开切口以进行疏散。使用内镜下氩等离子体凝固术切除囊肿壁。我们使用粘膜下隧道内镜切除术成功切除了内在肌层的食管支气管囊肿病变。
    结论:食管支气管囊肿临床少见,临床表现缺乏特异性。可以使用多种方法来确定病变的位置和性质,并最终确定治疗计划。手术切除和内镜治疗是两种不同的治疗方法,并且需要根据原始层选择合适的治疗方案,尺寸,与食管病变的关系,减少并发症,改善预后。
    BACKGROUND: Although esophageal bronchogenic cysts are benign diseases, they may be accompanied by serious complications and have the possibility of recurrence. Therefore, once confirmed, it is necessary to treat the esophagobronchial cyst when the contraindication is excluded. Endoscopic treatment is usually used for lesions with small diameter and shallow origin, and has the advantages of small surgical trauma and risk, which can reduce the psychological burden of patients to a certain extent, help them to recover quickly, and lower hospital costs.
    METHODS: Case 1 is a 54-year-old Han Chinese man admitted to our hospital who complained of difficulty swallowing in the past 6 months. Case 2 is a 41-year-old Han Chinese man who was hospitalized in the past 3 months due to chest discomfort. Endoscopic ultrasound revealed a hypoechoic cystic lesion arising from the muscularis propria. Submucosal tunneling endoscopic resection was performed using a dual knife, and a cystic mass was observed between the mucosa and the muscular layers of the esophagus. On locating the cyst, an incision was made on the oral side of the lesion for evacuation. The cyst wall was excised using endoscopic argon plasma coagulation. We successfully removed the esophageal bronchogenic cyst lesion in the intrinsic muscle layer using submucosal tunneling endoscopic resection.
    CONCLUSIONS: Esophageal bronchogenic cysts are rare in clinical practice and lack specificity in clinical manifestations. Multiple methods can be used to determine the location and nature of the lesion and ultimately determine the treatment plan. Surgical resection and endoscopic treatment are two different treatment methods, and appropriate treatment plans need to be selected on the basis of the origin layer, size, and relationship with the esophagus of the lesion to reduce complications and improve prognosis.
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  • 文章类型: Case Reports
    同时发生叶外肺隔离症,食管重复,支气管囊肿相对较低。我们报道了一个9个月大的中国儿童,他患有右肺囊肿,在子宫内检测到,并密切监测直至出生。在9个月大的时候,对比增强计算机断层扫描显示右纵隔叶外肺隔离症和两个囊肿。患者没有表现出任何异常。然而,父母担心这种疾病。在对家长进行积极的心理辅导后,手术是强烈的愿望。随后,成功进行了胸腔镜手术,切除三个病灶.术后无并发症发生。术后病理证实叶外肺隔离症合并食管重复和支气管囊肿。术后1个月和12个月随访,恢复良好,无异常空间占据。在这种情况下,术前应仔细检查影像学检查,术中探查应与手术前一致,以避免病变遗漏。
    The occurrence of simultaneous extralobar pulmonary sequestration, esophageal duplication, and bronchogenic cysts is relatively low. We report the case of a 9-month-old Chinese child who had a right lung cyst, detected in utero and was closely monitored until birth. At age 9 months, contrast-enhanced computed tomography revealed right mediastinal extralobar pulmonary sequestration and two cysts. The patient did not exhibit any abnormalities. However, the parents were concerned about the disease. Following positive psychological counseling to the parents, surgery was the strong desire. Subsequently, successful thoracoscopic surgery was performed, excising the three lesions. No postoperative complications occurred. Postoperative pathology confirmed extralobar pulmonary sequestration syndrome combined with esophageal duplication and bronchogenic cysts. The patient was followed-up at 1 and 12 months postoperatively and recovered well with no abnormal space occupation. In such cases, preoperative imaging examinations should be carefully performed, and intraoperative exploration should correspond to that before surgery to avoid lesion omission.
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  • 文章类型: Case Reports
    患者女,36岁,因“咽部异物感1个月余,呼吸困难15 d”就诊。门诊电子纤维喉镜提示,声门下一半球形肿物隆起,突入并堵塞气道90%,遂紧急行气管切开术。术前颈部增强CT见C6平面喉咽右侧壁软组织结节影凸向气管腔,边缘见低密度影。急诊在全身麻醉下行经口支撑喉镜下CO2激光声门下肿物切除术。病理标本大体检查示,肿瘤大小2.0 cm×1.0 cm,剖开内为黏稠胶冻样组织,囊壁厚0.2 cm,术后病理诊断为支气管源性囊肿。患者于术后第2天堵管,术后3 d出院,出院1年复查未见肿物复发,预后良好。.
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  • 文章类型: Case Reports
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  • 文章类型: Letter
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  • 文章类型: Journal Article
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  • 文章类型: Case Reports
    支气管囊肿(BC)是一种先天性异常,最常见于纵隔和肺,很少在隔膜中。我们报告了2例起源于左diaphragm肌的支气管囊肿。病例1涉及一名50岁的男性,他因高血压接受了肾上腺计算机断层扫描(CT),显示左肾上腺改变。我院肾上腺CT显示左膈上方有占位病变。我们在第七肋间间隙进行了左侧开胸手术,发现肿块完全位于隔膜中。病例2是一名58岁的女性,在标准健康检查下接受了胸部CT检查,在左下肺叶后基底段发现约4cm的胸膜下病变。在胸腔镜手术中,发现质量来自隔膜的表面,与肺组织无关。2例经手术病理证实为膈型支气管囊肿。由隔膜引起的异位支气管囊肿非常罕见,膈支气管囊肿通常发生在左侧,在女性中,在脊柱和隔膜之间的角度。据我们所知,没有与病例1类似的膈肌内BCs的相关报道,病例1完全位于膈肌内.大多数膈肌BCs位于膈肌表面,并向胸腔或腹腔突出。此外,双目膈支气管囊肿,与案例2类似,尚未报告。
    The bronchogenic cyst (BC) is a type of congenital anomaly that is most usually found in the mediastinum and lung, and rarely in the diaphragm. We report two cases of bronchogenic cysts originating from the left diaphragm. Case 1 involved a 50-year-old man who underwent computed tomography (CT) of the adrenal glands for hypertension, showing left adrenal changes. An adrenal CT at our hospital showed a space-occupying lesion above the left diaphragm. We performed a left-sided thoracotomy in the seventh intercostal space and found that the mass was entirely located in the diaphragm. Case 2 was a 58-year-old woman who underwent chest CT under a standard health check-up, and a subpleural lesion of approximately 4 cm was found in the posterior basal segment of the left inferior lung lobe. During thoracoscopic surgery, the mass was found to originate from the surface of the diaphragm, having no correlation with the lung tissue. The two cases of diaphragmatic bronchogenic cysts were confirmed by surgical pathology. Ectopic bronchogenic cysts arising from the diaphragm are very uncommon, and diaphragmatic bronchogenic cysts typically occur on the left side, in women, and in the angle between the vertebral column and the diaphragm. As far as we know, there are no relevant reports of intradiaphragmatic BCs similar to case 1, which was entirely located within the diaphragm. Most diaphragmatic BCs are located on the surface of the diaphragm and project toward the thoracic or abdominal cavities. Moreover, bilocular diaphragmatic bronchogenic cysts, similar to case 2, have not yet been reported.
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