Fine Needle Aspiration Diagnosis of Ciliated Hepatic Foregut Cysts

Hornstein, Abby M.; Batts, Kenneth P.; Linz, Laurie J.; Chang, Catherine D.; Galvanek, Eleonora G.; Bardawil, Ronald G.

doi:10.1159/000333919

Cited by 24 publications

(14 citation statements)

References 9 publications

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“…Detailed imaging investigations and serology will usually establish the diagnosis. Aspiration cytology has been used to diagnose a ciliated hepatic foregut cyst [11,13]. In contrast to previous recommendations, we consider that these rare lesions should be completely excised.…”

Section: Discussionmentioning

confidence: 83%

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Ciliated hepatic foregut cyst

Stringer

Jones

Woodley

et al. 2006

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 83%

“…However, in none of these cases was a communication between the cyst and the biliary tree confirmed. Interestingly, bile ductules have been identified within the fibrous capsule of the cyst in several cases [6,8,12,13].…”

Section: Discussionmentioning

confidence: 99%

Ciliated hepatic foregut cyst

Stringer

Jones

Woodley

et al. 2006

Journal of Pediatric Surgery

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“…In fact, some foregut cysts in the liver have been misdiagnosed by abdominal CT findings. 15,16 Generally, foregut cysts are not enhanced after the injection of contrast material, although slight enhancement was observed in the present case, which led us to suspect a malignant or hypovascular solid mass, or both. This phenomenon was considered to be due to the partial volume effect.…”

Section: Discussionmentioning

confidence: 46%

“…The solid part of the cyst was considered to have been formed from copious amorphous debris with sloughed epithelial cells. 15 Therefore, components that range in density and content, such as protein, lipid, or calcium, may account for the variable ultrasonographic characteristics. Ultrasonographic findings suggesting a solid component can lead to a misdiagnosis of malignant neoplasm before the pathogenesis is known.…”

Section: Discussionmentioning

confidence: 99%

Ciliated Foregut Cyst of the Gallbladder: Report of a Case

Muraoka¹,

Watanabe²,

Ikeda³

et al. 2003

Surgery Today

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We report the rare case of a gallbladder cyst arising from the foregut remnants. A 36-year-old woman was referred to our hospital after screening ultrasonography (US) detected a tumor in the gallbladder. On admission, she was well and her blood analyses were all normal. US showed a cystic mass with internal high-echoic lesions, and computed tomography (CT) demonstrated a protruding tumor with slight enhancement in the gallbladder. Angiography provided no additional information; however, sequential CT-arteriography (CTA) clearly demonstrated that this tumor was a cystic lesion. Surgical exploration was performed, first because of the difficulty in establishing a definite diagnosis, and also because the patient wanted the tumor removed. The resected specimen contained a unilocular cystic tumor that looked like a submucosal tumor. Histologically, the wall of the cyst was lined by ciliated stratified columnar epithelium with interspersed goblet cells and underlying smooth muscle fibers. The mass was finally diagnosed as a congenital ciliated foregut cyst of the gallbladder. Cysts of the gallbladder are uncommon and the majority are acquired. To our knowledge, this represents only the fourth report of a ciliated foregut cyst of the gallbladder in the literature. Although rare, an awareness of this entity could allow a preoperative diagnosis to be made, whereby surgical exploration may be avoided. CT-A is a very useful diagnostic tool, especially when the nature of the tumor presents a difficult differential diagnosis.

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“…Because CHFC is the only known ciliated lesion in the liver, aspiration cytology can give the diagnosis when it shows ciliated epithelial cells admixed with hepatocytes and mucous cells [4]. However, in case of extensive squamous metaplasia as in our case, it can miss the diagnosis.…”

Section: Discussionmentioning

confidence: 71%

Ciliated hepatic foregut cyst with extensive squamous metaplasia: report of a case

et al. 2006

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Ciliated hepatic foregut cysts (CHFC) are rare cystic lesions of the liver composed of a ciliated pseudostratified columnar epithelium with mucous cells, connective tissue, and smooth muscles bundles. We report the first case of CHFC with extensive squamous metaplasia without dysplasia or carcinoma. A unilocular, avascular, hypoechoic 60-mm liver lesion located in segment IV was detected by ultrasonography in a 31-year-old woman. The cyst was surgically removed and was lined mainly by a regular squamous epithelium without keratin formation. After extensive sampling, a ciliated pseudostratified columnar epithelium with some alcian blue-positive goblet cells was identified. The lesion was totally examined and there was no epithelial dysplasia or carcinoma. Squamous epithelium is very rare in hepatic foregut cysts and may degenerate into squamous carcinoma. Squamous epithelium is also described in biliary cysts. When squamous epithelium is identified in a liver cyst, an extensive sampling is recommended to identify possible foci of squamous carcinoma and to classify more precisely the histological type of the lesion. Because some cases of squamous carcinoma have been described in CHFC, surgical removal of the lesion may be more appropriate than close follow-up or sclerosing therapy.

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Fine Needle Aspiration Diagnosis of Ciliated Hepatic Foregut Cysts

Cited by 24 publications

References 9 publications

Ciliated hepatic foregut cyst

Ciliated hepatic foregut cyst

Ciliated Foregut Cyst of the Gallbladder: Report of a Case

Ciliated hepatic foregut cyst with extensive squamous metaplasia: report of a case

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