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Endoscopic Ultrasound Through-the-Needle Biopsy for the Diagnosis of an Abdominal Bronchogenic Cyst
Jessica Cassiani,Stefano Francesco Crinò,Erminia Manfrin,Matteo Rivelli,Armando Gabbrielli,Alfredo Guglielmi,Corrado Pedrazzani 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.5
A 57-year-old woman with epigastric pain was diagnosed with a 6-cm abdominal cystic lesion of unclear origin on cross-sectionalimaging. Endoscopic ultrasound (EUS) demonstrated a unilocular cyst located between the pancreas, gastric wall, and left adrenalgland, with a regular wall filled with dense fluid with multiple hyperechoic floating spots. A 19-G needle was used to puncture thecyst, but no fluid could be aspirated. Therefore, EUS-guided through-the-needle biopsy (EUS-TTNB) was performed. Histologicalanalysis 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 basedon the findings of the surgical specimen. Abdominal bronchogenic cysts are extremely uncommon, and a definitive diagnosis iscommonly obtained after the examination of surgical specimens due to the lack of pathognomonic findings on cross-sectionalimaging and poor cellularity on EUS-guided fine-needle aspiration cytology. EUS-TTNB is useful for establishing a preoperativehistological diagnosis, thus supporting the decision-making process.
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