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We read with interest the letter by Rubio et al, “Congenital bronchogenic cyst in the gastric mucosa” in the March 2005 issue.1 In their report, the cyst they discovered contained pseudostratified ciliated epithelium with a lymphatic follicle. No cartilage was noted and no respiratory seromucous glands were mentioned. Although all bronchogenic cysts must have ciliated epithelium (pseudostratified ciliated columnar or cuboidal epithelium), they must also have cartilage or bronchial mucous glands.2–5
Foregut cysts include bronchogenic, oesophageal, gastroenteric, and pericardial types. The most common location for these cysts is in the mediastinum; however, cutaneous, cervical, diaphragmatic, abdominal, retroperitoneal, and gastric locations have all been described. Although gastroenteric and pericardial cysts are straightforward to differentiate, the distinction between oesophageal and bronchogenic cysts can be difficult because of their similar histological features, as a result of their close embryological development. All bronchogenic cysts must have ciliated epithelium (pseudostratified ciliated columnar or cuboidal epithelium). They also must have cartilage or bronchial mucous glands. Oesophageal cysts can have ciliated or non-ciliated epithelium of columnar, squamous, or mixed types. This epithelium sits on two well developed layers of smooth muscle with no cartilage or respiratory glands. When a cyst is only lined by ciliated columnar epithelium with none of the above mentioned distinguishing features, a foregut cyst is the appropriate description.2–5
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