Benign Mediastinal Foregut Cyst



Benign Mediastinal Foregut Cyst







Key Facts


Terminology



  • Benign cystic tumors that are classified depending on epithelial lining


Etiology/Pathogenesis



  • So-called foregut cysts believed to arise due to abnormality during early gestational process in which laryngotracheal groove appears in ventral median aspect of primitive pharynx



    • Eventually develop into trachea and bronchial tree


Clinical Issues



  • Incidence



    • Accounts for approximately 10-20% of all mediastinal tumors


    • More common in children


    • More common in anterior mediastinum


  • Symptoms



    • Chest pain


    • Cough


    • Dyspnea


    • Asymptomatic


Top Differential Diagnoses



  • Multilocular thymic cyst


  • Cystic thymoma


Diagnostic Checklist



  • Identification of specific type of epithelium



    • Mesothelial


    • Respiratory


    • Columnar






Low-power view shows a mediastinal cyst composed of a strip of fibroconnective tissue with an epithelial lining image.






Bronchogenic cyst shows classical features of a lining of respiratory epithelium image and the presence of cartilage. These 2 components are important in the diagnosis.


TERMINOLOGY


Definitions



  • Benign cystic tumors that are classified depending on epithelial lining


ETIOLOGY/PATHOGENESIS


Developmental Anomaly



  • So-called foregut cysts may arise due to abnormality during early gestational process in which laryngotracheal groove appears in ventral median aspect of primitive pharynx



    • Eventually develops into trachea and bronchial tree


CLINICAL ISSUES


Epidemiology



  • Incidence



    • Unusual benign tumors that may account for 10-20% of all mediastinal tumors


  • Age



    • Mediastinal cysts are more common in children



      • However, may also occur in adults


  • Gender



    • No predilection


Site



  • More commonly seen in anterior and middle mediastinal compartment


Presentation



  • Chest pain


  • Cough


  • Dyspnea


  • Asymptomatic


Treatment



  • Surgical approaches



    • Complete surgical resection


Prognosis



  • Good


MACROSCOPIC FEATURES


General Features



  • Unilocular cystic tumors covered by glistening surface


Sections to Be Submitted



  • Numerous sections need to be submitted in order to identify specific epithelium to properly classify cyst


Size



  • Variable size from a few cm to > 10 cm in diameter


MICROSCOPIC PATHOLOGY


Histologic Features



  • Unilocular cyst, which may be lined by different types of epithelium



    • Respiratory epithelium


    • Columnar epithelium


    • Squamous epithelium


    • Mesothelial lining

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Jul 9, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Benign Mediastinal Foregut Cyst

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