Bronchogenic cyst differential diagnosis: Difference between revisions

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==[[Bronchogenic cyst differential diagnosis|Differentiating Bronchogenic cyst from other Diseases]]==
Bronchogenic cyst must be differentiated from [[Lung abscess physical examination|lung abcess]], [[Mediastinal mass differential diagnosis|thymic cyst]], and [[Mediastinal mass differential diagnosis|esophageal duplication cysts]]
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! rowspan="4"  style="background: #4479BA; color: #FFFFFF; text-align: center;|Diseases
| colspan="6" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;|'''Clinical manifestations'''
! colspan="7" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;|Para-clinical findings
| colspan="1" rowspan="4"  style="background: #4479BA; color: #FFFFFF; text-align: center;|'''Gold standard'''
|-
| colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;|'''Symptoms'''
! colspan="3" rowspan="2"  style="background: #4479BA; color: #FFFFFF; text-align: center;|Physical examination
|-
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;|Lab Findings
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;|Imaging
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;|Histopathology
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Symptom 1
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;|Symptom 2
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Symptom 3
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Physical exam 1
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;|Physical exam 2
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Physical exam 3
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Lab 1
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Lab 2
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Lab 3
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Imaging 1
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Imaging 2
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Imaging 3
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Lung abscess physical examination|Lung abcess]]<ref name="pmid26366400">{{cite journal| author=Kuhajda I, Zarogoulidis K, Tsirgogianni K, Tsavlis D, Kioumis I, Kosmidis C | display-authors=etal| title=Lung abscess-etiology, diagnostic and treatment options. | journal=Ann Transl Med | year= 2015 | volume= 3 | issue= 13 | pages= 183 | pmid=26366400 | doi=10.3978/j.issn.2305-5839.2015.07.08 | pmc=4543327 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26366400 }} </ref>
| style="background: #F5F5F5; padding: 5px;" |[[Fever]]
| style="background: #F5F5F5; padding: 5px;" |[[Chest pain]]
| style="background: #F5F5F5; padding: 5px;" |[[Sleep hyperhidrosis|night sweats]]
| style="background: #F5F5F5; padding: 5px;" |Dullness to [[percussion]]
| style="background: #F5F5F5; padding: 5px;" |[[Rales|coarse inspiratory crackles]]
| style="background: #F5F5F5; padding: 5px;" |Decreased [[breath sounds]]
| style="background: #F5F5F5; padding: 5px;" |[[Leukocytosis]]
| style="background: #F5F5F5; padding: 5px;" |Increased [[inflammation|inflamatory markers]] ([[Erythrocyte sedimentation rate|ESR]], [[C-reactive protein|CRP]])
| style="background: #F5F5F5; padding: 5px;" |[[Anemia of chronic disease]]
| style="background: #F5F5F5; padding: 5px;" |[[File: Frontal cxr of la.gif|x200px|thumb|Frontal view of  [[X-ray|CXR]] showing lung abscess with air-fluid level. Case courtesy of  Dr Abu-Rahmeh Zuhair (Picture courtesy: [https://radiopaedia.org/cases/lung-abscess-17?lang=gb Radiopaedia])]]
| style="background: #F5F5F5; padding: 5px;" |[[File: Lateral cxr of LA.gif|x200px|thumb|Lateral view 0f [[X-ray|CXR]] showing lung abscess with air-fluid level. Case courtesy of  Dr Abu-Rahmeh Zuhair (Picture courtesy: [https://radiopaedia.org/cases/lung-abscess-17?lang=gb Radiopaedia])]]
| style="background: #F5F5F5; padding: 5px;" |[[File:Ct la.gif|x200px|thumb| Non-contrast [[Computed tomography|CT]] showing lung abscess with air-fluid levels. Case courtesy of Dr Elsayed Mohamed Elsayed (Picture courtesy: [https://radiopaedia.org/cases/lung-abscess-6?lang=gb Radiopaedia])]]
| style="background: #F5F5F5; padding: 5px;" |
[[File:La.jpg|x200px|thumb|[[H&E]] stain showing lung abscess. Arrowhead – pink necrotic tissue with necrotic granulocytes and bacteria. Arrow – chronic inflammatory cells and dilated blood vessels (Picture courtesy: [https://webpath.med.utah.edu/LUNGHTML/LUNG023.html Webpath])]]
| style="background: #F5F5F5; padding: 5px;" |[[Computed tomography|CT]] with [[Radiocontrast|intravenous contrast]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Thymic cyst]]<ref name="pmid23225215">{{cite journal| author=Juanpere S, Cañete N, Ortuño P, Martínez S, Sanchez G, Bernado L| title=A diagnostic approach to the mediastinal masses. | journal=Insights Imaging | year= 2013 | volume= 4 | issue= 1 | pages= 29-52 | pmid=23225215 | doi=10.1007/s13244-012-0201-0 | pmc=3579993 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23225215  }} </ref>
| style="background: #F5F5F5; padding: 5px;" | [[Cough]]
| style="background: #F5F5F5; padding: 5px;" | [[Chest pain]]
| style="background: #F5F5F5; padding: 5px;" | [[Dyspnea]]
| style="background: #F5F5F5; padding: 5px;" | Some patients may present with a soft compressible [[Neck masses differential diagnosis|neck mass]]
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |[[File:THYMIC CYST XRAY.jpg|x200px|thumb| [[X-ray|x-ray]] scan showing a thymic mass (yellow arrowhead). Case courtesy of Dr. Stefan Ludwig (Picture courtesy: [https://radiopaedia.org/cases/thymic-cyst-1?lang=gb Radiopaedia])]]
| style="background: #F5F5F5; padding: 5px;" |[[File:THYMIC CYST CT.jpg|x200px|thumb| [[Computed tomography|CT]] scan showing a thymic mass corresponds to a cystic lesion (yellowarrow head). Case courtesy of Dr. Stefan Ludwig (Picture courtesy: [https://radiopaedia.org/cases/thymic-cyst-1?lang=gb Radiopaedia])]]
| style="background: #F5F5F5; padding: 5px;" |[[File:THYMIC CYST CALCIFIED.jpg|x200px|thumb| [[Computed tomography|CT]] scan showing a calcified thymic mass corresponds to a cystic lesion (yellow arrowhead). Case courtesy of Dr Bruno Di Muzio (Picture courtesy: [https://radiopaedia.org/cases/thymic-cyst-probable-1?lang=gb Radiopaedia])]]
| style="background: #F5F5F5; padding: 5px;" |[[File: Histopathology of thymic cyst.gif|x200px|thumb| H&E stain of [[thymic cyst]] showing bland squamous epithelium and some thymic tissue in its wall. Case courtesy of Dr Hanni Gulwani (Picture courtesy: [http://www.pathologyoutlines.com/topic/mediastinumthymiccyst.html Pathologyoutlines])]]
| style="background: #F5F5F5; padding: 5px;" |[[Biopsy]] with[[ histopathology]] and [[cytology]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Mediastinal mass differential diagnosis|Esophageal duplication cysts]]<ref name="pmid23225215">{{cite journal| author=Juanpere S, Cañete N, Ortuño P, Martínez S, Sanchez G, Bernado L| title=A diagnostic approach to the mediastinal masses. | journal=Insights Imaging | year= 2013 | volume= 4 | issue= 1 | pages= 29-52 | pmid=23225215 | doi=10.1007/s13244-012-0201-0 | pmc=3579993 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23225215  }} </ref><ref name="pmid25184121">{{cite journal| author=Liu R, Adler DG| title=Duplication cysts: Diagnosis, management, and the role of endoscopic ultrasound. | journal=Endosc Ultrasound | year= 2014 | volume= 3 | issue= 3 | pages= 152-60 | pmid=25184121 | doi=10.4103/2303-9027.138783 | pmc=4145475 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25184121  }} </ref><ref name="pmid23225215">{{cite journal| author=Juanpere S, Cañete N, Ortuño P, Martínez S, Sanchez G, Bernado L| title=A diagnostic approach to the mediastinal masses. | journal=Insights Imaging | year= 2013 | volume= 4 | issue= 1 | pages= 29-52 | pmid=23225215 | doi=10.1007/s13244-012-0201-0 | pmc=3579993 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23225215  }} </ref>
| style="background: #F5F5F5; padding: 5px;" |[[sternum|Retrosternal]] and [[chest|thoracic]] [[back pain]]
| style="background: #F5F5F5; padding: 5px;" |[[Epigastric]] discomfort
| style="background: #F5F5F5; padding: 5px;" |[[Dysphagia]]
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px;" |[[File: Endoscopic view of an esophageal duplication cyst.jpg|x200px|thumb|[[Endoscopy|endoscopic]] view of an esophageal duplication cyst (Picture courtesy: [http://www.eusjournal.com/article.asp?issn=2303-9027;year=2014;volume=3;issue=3;spage=152;epage=160;aulast=Liu#ref3 Endoscopic ultrasound])]]
| style="background: #F5F5F5; padding: 5px;" |[[File: Barium swallowing EDC.jpeg|x200px|thumb| [[X-rays|X-ray]] post barium swallow showing an oval mass compressing the esophagus. Case courtesy of  Dr Michael P Hartung (Picture courtesy: [https://radiopaedia.org/cases/oesophageal-duplication-cyst-3?lang=gb Radiopaedia])]]
| style="background: #F5F5F5; padding: 5px;" |[[File:EDC CT YA.jpeg|x200px|thumb|[[Computed tomography|CT]] showing an esophageal duplication cyst. Case courtesy of Assoc Prof Craig Hacking (Picture courtesy: [https://radiopaedia.org/cases/superior-mediastinal-mass-due-to-oesophageal-duplication-cyst?lang=gb Radiopaedia])]]
| style="background: #F5F5F5; padding: 5px;" |[[File: Histopath EDC.jpg|x200px|thumb|Histologic image of an esophageal duplication cyst showing two-layered muscle coat like the [[Gastrointestinal tract|GIT]], and epithelium lining of pseudo-ciliated columnar cells. (Picture courtesy: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2810603/ National Center for Biotechnology Information])]]
| style="background: #F5F5F5; padding: 5px;" |[[Endoscopic ultrasound]]
*Anechoic or hypoechoic, homogenous lesions
*Regular margins originating from the submucosal layer or outside of the gut wall(adventitia)
 
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
|}
 


==References==
==References==

Revision as of 19:55, 13 July 2020

Differentiating Bronchogenic cyst from other Diseases

Bronchogenic cyst must be differentiated from lung abcess, thymic cyst, and esophageal duplication cysts

Diseases Clinical manifestations Para-clinical findings Gold standard
Symptoms Physical examination
Lab Findings Imaging Histopathology
Symptom 1 Symptom 2 Symptom 3 Physical exam 1 Physical exam 2 Physical exam 3 Lab 1 Lab 2 Lab 3 Imaging 1 Imaging 2 Imaging 3
Lung abcess[1] Fever Chest pain night sweats Dullness to percussion coarse inspiratory crackles Decreased breath sounds Leukocytosis Increased inflamatory markers (ESR, CRP) Anemia of chronic disease
Frontal view of CXR showing lung abscess with air-fluid level. Case courtesy of Dr Abu-Rahmeh Zuhair (Picture courtesy: Radiopaedia)
Lateral view 0f CXR showing lung abscess with air-fluid level. Case courtesy of Dr Abu-Rahmeh Zuhair (Picture courtesy: Radiopaedia)
Non-contrast CT showing lung abscess with air-fluid levels. Case courtesy of Dr Elsayed Mohamed Elsayed (Picture courtesy: Radiopaedia)
H&E stain showing lung abscess. Arrowhead – pink necrotic tissue with necrotic granulocytes and bacteria. Arrow – chronic inflammatory cells and dilated blood vessels (Picture courtesy: Webpath)
 CT with intravenous contrast
Thymic cyst[2] Cough Chest pain Dyspnea Some patients may present with a soft compressible neck mass - - - - -
x-ray scan showing a thymic mass (yellow arrowhead). Case courtesy of Dr. Stefan Ludwig (Picture courtesy: Radiopaedia)
CT scan showing a thymic mass corresponds to a cystic lesion (yellowarrow head). Case courtesy of Dr. Stefan Ludwig (Picture courtesy: Radiopaedia)
CT scan showing a calcified thymic mass corresponds to a cystic lesion (yellow arrowhead). Case courtesy of Dr Bruno Di Muzio (Picture courtesy: Radiopaedia)
H&E stain of thymic cyst showing bland squamous epithelium and some thymic tissue in its wall. Case courtesy of Dr Hanni Gulwani (Picture courtesy: Pathologyoutlines)
 Biopsy withhistopathology and cytology
Esophageal duplication cysts[2][3][2] Retrosternal and thoracic back pain Epigastric discomfort Dysphagia - - - - - -
endoscopic view of an esophageal duplication cyst (Picture courtesy: Endoscopic ultrasound)
X-ray post barium swallow showing an oval mass compressing the esophagus. Case courtesy of Dr Michael P Hartung (Picture courtesy: Radiopaedia)
CT showing an esophageal duplication cyst. Case courtesy of Assoc Prof Craig Hacking (Picture courtesy: Radiopaedia)
Histologic image of an esophageal duplication cyst showing two-layered muscle coat like the GIT, and epithelium lining of pseudo-ciliated columnar cells. (Picture courtesy: National Center for Biotechnology Information)
 Endoscopic ultrasound
  • Anechoic or hypoechoic, homogenous lesions
  • Regular margins originating from the submucosal layer or outside of the gut wall(adventitia)


References

  1. ↑ Kuhajda I, Zarogoulidis K, Tsirgogianni K, Tsavlis D, Kioumis I, Kosmidis C; et al. (2015). "Lung abscess-etiology, diagnostic and treatment options". Ann Transl Med. 3 (13): 183. doi:10.3978/j.issn.2305-5839.2015.07.08. PMC 4543327. PMID 26366400.
  2. ↑ 2.0 2.1 2.2 Juanpere S, Cañete N, Ortuño P, Martínez S, Sanchez G, Bernado L (2013). "A diagnostic approach to the mediastinal masses". Insights Imaging. 4 (1): 29–52. doi:10.1007/s13244-012-0201-0. PMC 3579993. PMID 23225215.
  3. ↑ Liu R, Adler DG (2014). "Duplication cysts: Diagnosis, management, and the role of endoscopic ultrasound". Endosc Ultrasound. 3 (3): 152–60. doi:10.4103/2303-9027.138783. PMC 4145475. PMID 25184121.

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