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| ==[[Bronchogenic cyst overview|Overview]]== | | ==[[Bronchogenic cyst overview|Overview]]== |
| Bronchogenic [[cyst]] is a rare [[benign]] [[congenital malformation]] of the [[respiratory tract|tracheobronchial tree]] derived from the ventral aspect of the [[foregut]]. It most frequently occurs in the middle mediastinum, in the early stages of [[gestation]] or in the lungs, at the later stages of gestation. Atypical locations may be explained by its embryologic origin.
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| Patients with bronchogenic [[cyst]] may be asymptomatic or present with [[respiratory distress]], increasing [[stridor]], feeding difficulties, [[chest pain]], [[cough]], progressive [[dysphagia]], [[odynophagia]], purulent sputum, [[dyspnea]], [[anorexia]] and/or[[ weight loss]].
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| Radiologic findings are useful to differentiate bronchogenic [[cysts]] from other [[cysts]] but may they not always confirm the diagnosis. Diagnosis is confirmed by surgical excision, which is curative, and histological findings of ciliated [[columnar epithelial]] lining of the [[cyst]].
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| ==[[Bronchogenic cyst historical perspective|Historical Perspective]]== | | ==[[Bronchogenic cyst historical perspective|Historical Perspective]]== |
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| ==Diagnosis== | | ==Diagnosis== |
| [[Bronchogenic cyst Diagnostic Study of Choice|Diagnostic Study of Choice]] | [[Bronchogenic cyst History and Symptoms|History and Symptoms]] | [[Bronchogenic cyst Physical Examination|Physical Examination]] | [[Bronchogenic cyst Laboratory Findings|Laboratory Findings]] | [[Bronchogenic cyst electrocardiogram|Electrocardiogram]] | [[Bronchogenic cyst Echocardiography and Ultrasound|Echocardiography and Ultrasound]] | [[Bronchogenic cysts CT|CT]] | [[Bronchogenic cyst MRI|MRI]] | [[Bronchogenic cyst Ultrasound|Ultrasound]] | [[Bronchogenic cyst Other imaging findings|Other imaging findings]] | [[Bronchogenic cyst Other Diagnostic Studies|Other Diagnostic Studies]] | | [[Bronchogenic cyst Diagnostic Study of Choice|Diagnostic Study of Choice]] | [[Bronchogenic cyst History and Symptoms|History and Symptoms]] | [[Bronchogenic cyst Physical Examination|Physical Examination]] | [[Bronchogenic cyst Laboratory Findings|Laboratory Findings]] | [[Bronchogenic cyst electrocardiogram|Electrocardiogram]] | [[Bronchogenic cyst X-ray|X-ray]] | [[Bronchogenic cyst Electrocardiography and ultrasound|Electrocardiography and ultrasound]] | [[Bronchogenic cysts CT|CT]] | [[Bronchogenic cyst MRI|MRI]] | [[Bronchogenic cyst Ultrasound|Ultrasound]] | [[Bronchogenic cyst Other imaging findings|Other imaging findings]] | [[Bronchogenic cyst Other Diagnostic Studies|Other Diagnostic Studies]] |
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| ==Treatment== | | ==Treatment== |
| [[Bronchogenic cyst medical therapy|Medical Therapy]] | [[Bronchogenic cyst surgery|Surgery]] | [[Bronchogenic cyst primary prevention|Primary Prevention]] | [[Bronchogenic cyst secondary prevention|Secondary Prevention]] | [[Bronchogenic cyst cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Bronchogenic cyst future or investigational therapies|Future or Investigational Therapies]] | | [[Bronchogenic cyst medical therapy|Medical Therapy]] | [[Bronchogenic cyst intervention|Intervention]] | [[Bronchogenic cyst surgery|Surgery]] | [[Bronchogenic cyst primary prevention|Primary Prevention]] | [[Bronchogenic cyst secondary prevention|Secondary Prevention]] | [[Bronchogenic cyst cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Bronchogenic cyst future or investigational therapies|Future or Investigational Therapies]] |
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| [[Surgery]]
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| Surgery is the mainstay of treatment for bronchogenic [[cyst]] even when the patients are asymptomatic,<ref name="pmid31462259">{{cite journal| author=Yang X, Zong Y, Zhao HY, Wu YD, Ji M| title=Complete excision of esophageal bronchogenic cyst by endoscopic submucosal tunnel dissection: a case presentation. | journal=BMC Gastroenterol | year= 2019 | volume= 19 | issue= 1 | pages= 155 | pmid=31462259 | doi=10.1186/s12876-019-1072-3 | pmc=6714396 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31462259 }} </ref>conservative approach is not approved.<ref name="pmid8902460">{{cite journal| author=Aktoğu S, Yuncu G, Halilçolar H, Ermete S, Buduneli T| title=Bronchogenic cysts: clinicopathological presentation and treatment. | journal=Eur Respir J | year= 1996 | volume= 9 | issue= 10 | pages= 2017-21 | pmid=8902460 | doi=10.1183/09031936.96.09102017 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8902460 }} </ref> Surgery is imperative with symptoms such as <ref name="pmid12809250">{{cite journal| author=Sarper A, Ayten A, Golbasi I, Demircan A, Isin E| title=Bronchogenic cyst. | journal=Tex Heart Inst J | year= 2003 | volume= 30 | issue= 2 | pages= 105-8 | pmid=12809250 | doi= | pmc=161894 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12809250 }} </ref>
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| *[[Dyspnea]]
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| *[[Dysphagia]]
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| *Pain
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| *Purulent [[sputum]]
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| *[[Hemoptysis]]
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| Most commonly used approaches for complete excision of bronchogenic [[cysts]] are<ref name="pmid12809250">{{cite journal| author=Sarper A, Ayten A, Golbasi I, Demircan A, Isin E| title=Bronchogenic cyst. | journal=Tex Heart Inst J | year= 2003 | volume= 30 | issue= 2 | pages= 105-8 | pmid=12809250 | doi= | pmc=161894 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12809250 }} </ref><ref name="pmid26986156">{{cite journal| author=Han C, Lin R, Yu J, Zhang Q, Zhang Y, Liu J | display-authors=etal| title=A Case Report of Esophageal Bronchogenic Cyst and Review of the Literature With an Emphasis on Endoscopic Ultrasonography Appearance. | journal=Medicine (Baltimore) | year= 2016 | volume= 95 | issue= 11 | pages= e3111 | pmid=26986156 | doi=10.1097/MD.0000000000003111 | pmc=4839937 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26986156 }} </ref><ref name="pmid31462259">{{cite journal| author=Yang X, Zong Y, Zhao HY, Wu YD, Ji M| title=Complete excision of esophageal bronchogenic cyst by endoscopic submucosal tunnel dissection: a case presentation. | journal=BMC Gastroenterol | year= 2019 | volume= 19 | issue= 1 | pages= 155 | pmid=31462259 | doi=10.1186/s12876-019-1072-3 | pmc=6714396 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31462259 }} </ref><ref name="pmid30846076">{{cite journal| author=Ayub II, Balakrishnan H, Arshad AM, Manimaran N, Thangaswamy D, Chockalingam C| title=A 44-Year-Old Man With Nonproductive Cough and Sensation of Heaviness Over the Upper Chest. | journal=Chest | year= 2019 | volume= 155 | issue= 3 | pages= e65-e68 | pmid=30846076 | doi=10.1016/j.chest.2018.09.035 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30846076 }} </ref>
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| *[[Thoracotomy]]
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| *[[Thoracoscopy]]
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| Other procedures include
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| *Endoscopic submucosal tunnel dissection<ref name="pmid31462259">{{cite journal| author=Yang X, Zong Y, Zhao HY, Wu YD, Ji M| title=Complete excision of esophageal bronchogenic cyst by endoscopic submucosal tunnel dissection: a case presentation. | journal=BMC Gastroenterol | year= 2019 | volume= 19 | issue= 1 | pages= 155 | pmid=31462259 | doi=10.1186/s12876-019-1072-3 | pmc=6714396 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31462259 }} </ref><ref name="pmid26986156">{{cite journal| author=Han C, Lin R, Yu J, Zhang Q, Zhang Y, Liu J | display-authors=etal| title=A Case Report of Esophageal Bronchogenic Cyst and Review of the Literature With an Emphasis on Endoscopic Ultrasonography Appearance. | journal=Medicine (Baltimore) | year= 2016 | volume= 95 | issue= 11 | pages= e3111 | pmid=26986156 | doi=10.1097/MD.0000000000003111 | pmc=4839937 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26986156 }} </ref>
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| *Percutaneous catheter drainage or endoscopic ultrasonographic guided-fine needle aspiration<ref name="pmid26986156">{{cite journal| author=Han C, Lin R, Yu J, Zhang Q, Zhang Y, Liu J | display-authors=etal| title=A Case Report of Esophageal Bronchogenic Cyst and Review of the Literature With an Emphasis on Endoscopic Ultrasonography Appearance. | journal=Medicine (Baltimore) | year= 2016 | volume= 95 | issue= 11 | pages= e3111 | pmid=26986156 | doi=10.1097/MD.0000000000003111 | pmc=4839937 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26986156 }} </ref> with sterile alcohol ablation has been used in selected high-risk patients, especially adults, but has no place in pediatric therapeutics.<ref name="pmid19015445">{{cite journal| author=Teissier N, Elmaleh-Bergès M, Ferkdadji L, François M, Van den Abbeele T| title=Cervical bronchogenic cysts: usual and unusual clinical presentations. | journal=Arch Otolaryngol Head Neck Surg | year= 2008 | volume= 134 | issue= 11 | pages= 1165-9 | pmid=19015445 | doi=10.1001/archotol.134.11.1165 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19015445 }} </ref>
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| *[[thoracoscopy|video-assisted thorascopic surgery]]<ref name="pmid25131363">{{cite journal| author=Legras A, Mordant P, Gibault L, Hernigou A, Le Pimpec Barthes F, Riquet M| title=[Diaphragmatic bronchogenic cyst: an exceptional location]. | journal=Rev Pneumol Clin | year= 2014 | volume= 70 | issue= 6 | pages= 357-61 | pmid=25131363 | doi=10.1016/j.pneumo.2014.05.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25131363 }} </ref><ref name="pmid26986156">{{cite journal| author=Han C, Lin R, Yu J, Zhang Q, Zhang Y, Liu J | display-authors=etal| title=A Case Report of Esophageal Bronchogenic Cyst and Review of the Literature With an Emphasis on Endoscopic Ultrasonography Appearance. | journal=Medicine (Baltimore) | year= 2016 | volume= 95 | issue= 11 | pages= e3111 | pmid=26986156 | doi=10.1097/MD.0000000000003111 | pmc=4839937 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26986156 }} </ref><ref name="pmid30846076">{{cite journal| author=Ayub II, Balakrishnan H, Arshad AM, Manimaran N, Thangaswamy D, Chockalingam C| title=A 44-Year-Old Man With Nonproductive Cough and Sensation of Heaviness Over the Upper Chest. | journal=Chest | year= 2019 | volume= 155 | issue= 3 | pages= e65-e68 | pmid=30846076 | doi=10.1016/j.chest.2018.09.035 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30846076 }} </ref><ref name="pmid25038917">{{cite journal| author=Jung HS, Kim DK, Lee GD, Sim HJ, Choi SH, Kim HR | display-authors=etal| title=Video-assisted thoracic surgery for bronchogenic cysts: is this the surgical approach of choice? | journal=Interact Cardiovasc Thorac Surg | year= 2014 | volume= 19 | issue= 5 | pages= 824-9 | pmid=25038917 | doi=10.1093/icvts/ivu228 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25038917 }} </ref>
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| *Transtracheal needle aspiration<ref name="pmid3562032">{{cite journal| author=Cohn JR, Wechsler R, Zawid J, Brodovsky HS| title=Resolution of a mediastinal cyst by transtracheal needle aspiration. | journal=Pa Med | year= 1987 | volume= 90 | issue= 3 | pages= 64, 66 | pmid=3562032 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3562032 }} </ref>
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| *[[Craniotomy]] with resection for cranial bronchogenic [[cyst]]craniotomy with resection<ref name="pmid31348319">{{cite journal| author=Bian B, Yu M, Liu S, Li S, Wei Y, Zhang B| title=A suprasellar bronchogenic cyst: A case report. | journal=Medicine (Baltimore) | year= 2019 | volume= 98 | issue= 30 | pages= e16650 | pmid=31348319 | doi=10.1097/MD.0000000000016650 | pmc=6709100 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31348319 }} </ref>
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| *[[Median sternotomy|Sternotomy]] for cardiac [[cyst]]<ref name="pmid26234845">{{cite journal| author=Olsen M, Mitchell TA, Percival TJ, Helsel BS| title=Interatrial Bronchogenic Cyst Resection. | journal=Ann Thorac Surg | year= 2015 | volume= 100 | issue= 2 | pages= 709-11 | pmid=26234845 | doi=10.1016/j.athoracsur.2014.10.025 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26234845 }} </ref>
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| *[[Laminectomy]] for intraspinal [[cyst]]<ref name="pmid26097578">{{cite journal| author=Zou MX, Hu JR, Kang YJ, Li J, Lv GH, She XL| title=Bronchogenic cyst of the conus medullaris with spinal cord tethering: a case report and review of the literature. | journal=Int J Clin Exp Pathol | year= 2015 | volume= 8 | issue= 4 | pages= 3937-42 | pmid=26097578 | doi= | pmc=4466965 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26097578 }} </ref><ref name="pmid29390371">{{cite journal| author=Lee HD, Han SH, Park SB, Ko Y, Lee KH| title=An intradural extramedullary bronchogenic cyst in the thoracolumbar spine: A case report. | journal=Medicine (Baltimore) | year= 2017 | volume= 96 | issue= 50 | pages= e9263 | pmid=29390371 | doi=10.1097/MD.0000000000009263 | pmc=5815783 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29390371 }} </ref>
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| *[[ICD-9-CM Volume 3|Marsupialisation]]<ref name="pmid28762109">{{cite journal| author=Candy N, Young A, Devadass A, Dean A, McMillen J, Trivedi R| title=Dual lumbar bronchogenic and arachnoid cyst presenting with sciatica and left foot drop. | journal=Acta Neurochir (Wien) | year= 2017 | volume= 159 | issue= 10 | pages= 2029-2032 | pmid=28762109 | doi=10.1007/s00701-017-3284-z | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28762109 }} </ref>
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| Complete surgical [[resection]] is curative.<ref name="pmid19015445">{{cite journal| author=Teissier N, Elmaleh-Bergès M, Ferkdadji L, François M, Van den Abbeele T| title=Cervical bronchogenic cysts: usual and unusual clinical presentations. | journal=Arch Otolaryngol Head Neck Surg | year= 2008 | volume= 134 | issue= 11 | pages= 1165-9 | pmid=19015445 | doi=10.1001/archotol.134.11.1165 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19015445 }} </ref><ref name="pmid480084">{{cite journal| author=Ramenofsky ML, Leape LL, McCauley RG| title=Bronchogenic cyst. | journal=J Pediatr Surg | year= 1979 | volume= 14 | issue= 3 | pages= 219-24 | pmid=480084 | doi=10.1016/s0022-3468(79)80474-1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=480084 }} </ref> Risk during surgery is usually low, [[complication|complications]] include but are not limited to persistent air leak,<ref name="pmid12809250">{{cite journal| author=Sarper A, Ayten A, Golbasi I, Demircan A, Isin E| title=Bronchogenic cyst. | journal=Tex Heart Inst J | year= 2003 | volume= 30 | issue= 2 | pages= 105-8 | pmid=12809250 | doi= | pmc=161894 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12809250 }} </ref> pulmonary and vascular compressions, vascular, pleural, tracheobronchial, pulmonary, mediastinal and diaphragmatic [[adhesion|adhesions]],<ref name="pmid8902460">{{cite journal| author=Aktoğu S, Yuncu G, Halilçolar H, Ermete S, Buduneli T| title=Bronchogenic cysts: clinicopathological presentation and treatment. | journal=Eur Respir J | year= 1996 | volume= 9 | issue= 10 | pages= 2017-21 | pmid=8902460 | doi=10.1183/09031936.96.09102017 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8902460 }} </ref> inflammatory [[stenosis]],<ref name="pmid26112048">{{cite journal| author=Thaller P, Blanchet C, Badr M, Mesnage R, Leboucq N, Mondain M | display-authors=etal| title=Neonatal respiratory distress syndrome revealing a cervical bronchogenic cyst: a case report. | journal=BMC Pediatr | year= 2015 | volume= 15 | issue= | pages= 72 | pmid=26112048 | doi=10.1186/s12887-015-0363-2 | pmc=4491209 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26112048 }} </ref> and [[Third degree AV block|thrid degree heart block]].<ref name="pmid26234845">{{cite journal| author=Olsen M, Mitchell TA, Percival TJ, Helsel BS| title=Interatrial Bronchogenic Cyst Resection. | journal=Ann Thorac Surg | year= 2015 | volume= 100 | issue= 2 | pages= 709-11 | pmid=26234845 | doi=10.1016/j.athoracsur.2014.10.025 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26234845 }} </ref>
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| ==Case Studies== | | ==Case Studies== |
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| [[CME Category::Cardiology]] | | [[CME Category::Pulmonology]] |
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| [[Category:Cardiology]] | | [[Category:Cardiology]] |