Clinicopathological and endoscopic ultrasonography characteristics of esophageal bronchogenic cysts: A single-center study.

BACKGROUND

Esophageal bronchogenic cysts (EBCs) are usually discovered incidentally during radiologic or endoscopic examinations. They are rare and prone to misdiagnosis or mistreatment. As a submucosal lesion, the endoscopic ultrasonography (EUS) characteristics of EBCs are unclear.

AIM

To analyze the clinicopathological and EUS characteristics of EBCs.

METHODS

A total of 22 patients with a histological diagnosis of EBCs who underwent EUS examination were retrospectively included. The clinicopathological and EUS features were collected and analyzed.

RESULTS

Most of the EBCs were asymptomatic, and no malignant transformation or precancerous changes was found histologically. Most of the EBCs were located in the lower esophagus (72.7%, 16/22). A total of 90.9% (20/22) of the EBCs originated from the muscularis propria, and 9.1% (2/22) originated from the submucosa. All of the lesions had clear boundaries. In terms of echo, 77.3% (17/22) had a hypoechoic pattern, and 22.7% (5/22) had an anechoic pattern. We found floating echoes inside the lesion, which presented as a punctiform hyperecho in 45.5% (10/22) and a flocculent hypoecho in 36.4% (8/22) of the patients. A total of 45.5% (10/22) displayed posterior wall enhancement. Fourteen patients underwent color doppler, and no blood flow signal was identified. On EUS elastography, the EBCs presented a yellow-green or green pattern (100%, 6/6). When contrast-enhanced EUS was used, the EBCs showed no enhancement (100%, 5/5).

CONCLUSION

When a submucosal lesion located at the lower esophagus originates from the intrinsic muscle layer, the possibility of EBCs should be noted, the EUS characteristics of which include a hypoecho with a clear boundary and a posterior wall enhancement, a floating echo inside and no blood flow signal, a yellow-green or green pattern on elastography, and no enhancement on contrast EUS.