Gastric bronchogenic cyst: a rare congenital cystic lesion of the stomach

Excerpt

A woman in her 30s who presented with epigastric pain was admitted to our hospital. Her blood test showed only mildly elevated CA19-9 (55.8 U/mL). Abdominal ultrasonography (AUS) (Canon Aplio500 equipped with 3.5-MHz transducer) indicated a hypoechoic mass-like lesion with a maximum diameter of 26 mm between the left lobe of the liver and the lesser curvature of the gastric wall. The lesion was attached to the gastric wall and was separated from the liver by a single layer of the hyperechoic membrane (Fig. 1a). Moreover, an anechoic lesion was indicated inside the lesion, and color Doppler imaging showed no signal (Fig. 1b). Endoscopic ultrasonography (EUS) showed that the tumor had originated from the fourth layer of the stomach (Fig. 1c). Contrast-enhanced computed tomography (CT) revealed a low-density area of suspected cystic change inside the tumor, with a prolonged contrast effect at the margins (Fig. 1d–g). Magnetic resonance imaging (MRI) showed low intensity on T1-weighted imaging (T1WI) and high intensity on T2WI in the tumor (Fig. 1h, i). Positron emission tomography (PET)-CT showed mild accumulation of fluorodeoxyglucose (FDG) (SUV_max = 3.4), partially in the delay phase (Fig. 1j). Therefore, an exophytic type of gastrointestinal stromal tumor (GIST) with cystic degeneration or schwannoma was suspected, and she underwent local laparoscopic resection of the tumor (Fig. 1k). The resected specimen was a smooth-surfaced multicystic lesion measuring 8 mm × 25 mm × 20 mm with yellowish mucus inside (Fig. 1l). The histopathological image revealed a ciliated, respiratory-type epithelium with goblet cells (Fig. 1m). Based on these findings, the lesion was diagnosed as a gastric bronchogenic cyst (BC).

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