Clinicopathological and endoscopic ultrasonography characteristics of esophageal bronchogenic cysts: A single-center study.

Background: Esophageal bronchogenic cysts (EBCs) are usually discovered incidentally during radiologic or endoscopic examinations. They are rare and prone to misdiagnosis or mistreatment. As a submucosal lesion, the endoscopic ultrasonography (EUS) characteristics of EBCs are unclear.

Aim: To analyze the clinicopathological and EUS characteristics of EBCs.

Methods: A total of 22 patients with a histological diagnosis of EBCs who underwent EUS examination were retrospectively included. The clinicopathological and EUS features were collected and analyzed.

Results: Most of the EBCs were asymptomatic, and no malignant transformation or precancerous changes was found histologically. Most of the EBCs were located in the lower esophagus (72.7%, 16/22). A total of 90.9% (20/22) of the EBCs originated from the muscularis propria, and 9.1% (2/22) originated from the submucosa. All of the lesions had clear boundaries. In terms of echo, 77.3% (17/22) had a hypoechoic pattern, and 22.7% (5/22) had an anechoic pattern. We found floating echoes inside the lesion, which presented as a punctiform hyperecho in 45.5% (10/22) and a flocculent hypoecho in 36.4% (8/22) of the patients. A total of 45.5% (10/22) displayed posterior wall enhancement. Fourteen patients underwent color doppler, and no blood flow signal was identified. On EUS elastography, the EBCs presented a yellow-green or green pattern (100%, 6/6). When contrast-enhanced EUS was used, the EBCs showed no enhancement (100%, 5/5).

Conclusion: When a submucosal lesion located at the lower esophagus originates from the intrinsic muscle layer, the possibility of EBCs should be noted, the EUS characteristics of which include a hypoecho with a clear boundary and a posterior wall enhancement, a floating echo inside and no blood flow signal, a yellow-green or green pattern on elastography, and no enhancement on contrast EUS.