Clin Endosc > Epub ahead of print
Endoscopic Ultrasound Through-the-Needle Biopsy for the Diagnosis of an Abdominal Bronchogenic Cyst
Jessica Cassiani1 , Stefano Francesco Crinò2 , Erminia Manfrin3 , Matteo Rivelli1 , Armando Gabbrielli2 , Alfredo Guglielmi1 , Corrado Pedrazzani1
1Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Unit of General and Hepatobiliary Surgery, University of Verona Hospital Trust, University of Verona, Verona, Italy
2Department of Medicine, Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, University of Verona Hospital Trust, University of Verona, Verona, Italy
3Department of Diagnostic and Public Health, University of Verona Hospital Trust, University of Verona, Verona, Italy
Correspondence :  Stefano Francesco Crinò ,Tel: +39-045-812-6191, Fax: +39-045-812-8191, Email: stefanocrino@hotmail.com
Received: July 22, 2020  Revised: September 15, 2020   Accepted: October 17, 2020
Abstract
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.
Key Words: Bronchogenic cyst; Endoscopic ultrasound-guided fine needle aspiration; Endoscopic ultrasound-guided through-the-needle biopsy; Laparoscopy; Pancreatic cyst
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