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A ciliated cyst with müllerian differentiation arising in the posterior mediastinum.

Lee SJ, Hwang CS, Park do Y, Huh GY, Lee CH - Korean J Pathol (2014)

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Pusan National University School of Medicine, Yangsan, Korea.

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We found a posterior mediastinal cyst with Müllerian differentiation that was consistent with previous description of Hattori’s cyst... To our knowledge, this is the first report of Hattori’s cyst arising in the posterior mediastinum in Korea... An abnormal mass lesion in the posterior mediastinum of a 42-year-old woman was found incidentally during a routine medical check-up... The cystic wall was lined by a simple ciliated cuboidal to columnar epithelium supported by thin connective tissue... Some H-caldesmon positive bundles of smooth muscle cells were found (Fig. 2B)... The epithelium of the papillary structure was composed of ciliated pseudostratified columnar and intercalated clear cells (Fig. 2C)... We did not identify any atypia in the epithelial cells... The pathologic diagnosis was benign ciliated cyst of the posterior mediastinum showing Müllerian differentiation, suggestive of the so-called mediastinal Hattori’s cyst... Thus, because the histogenesis of these structures is still not understood, the descriptive term ‘ciliated cyst with Müllerian differentiation’ may be more appropriate for the designation of these cysts... Before Hattori suggested Hattori’s cyst as a new disease entity, mediastinal cysts with Müllerian differentiation were misdiagnosed as bronchogenic cysts due to their ciliated epithelium... Compared with bronchogenic cysts, the lining epithelium of cystic structures with Müllerian differentiation do not have cartilage structure and are ER and PR positive... ER, PR, and PAX-8, which show positivity to epithelial cells in the present case, are known to be the best markers of Müllerian cysts... Additionally, the lining epithelial cells of the present case were positive for CK7, and negative for CK5/6 and calretinin, which are specific for mesothelial differentiation.

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(A) Chest magnetic resonance imaging shows a paravertebral cystic mass in the posterior mediastinum (white arrow). The mass has a high intensity signal on T2-weighted image, equal to the signal intensity of water. (B) A resected specimen reveals a thin-walled, translucent unilocular cyst, filled with clear serous fluid.
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f1-kjpathol-48-5-401: (A) Chest magnetic resonance imaging shows a paravertebral cystic mass in the posterior mediastinum (white arrow). The mass has a high intensity signal on T2-weighted image, equal to the signal intensity of water. (B) A resected specimen reveals a thin-walled, translucent unilocular cyst, filled with clear serous fluid.

Mentions: An abnormal mass lesion in the posterior mediastinum of a 42-year-old woman was found incidentally during a routine medical check-up. Well-defined cystic lesion, measuring about 2.6 cm in diameter, and arising in the right paraspinal mediastinum was noted on magnetic resonance imaging and computed tomography of the chest. The mass exhibited high signal intensity on T1-weighted imaging and low signal intensity on T2-weighted imaging, which suggested that the lesion was purely cystic (Fig. 1A). The differential diagnosis based on radiologic imaging included a bronchogenic cyst or neurogenic tumor with cystic change. She underwent video-assisted thoracoscopic surgery for the excision of the mass. The mass was a unilocular cyst with thin, lucent walls filled with clear serous fluid (Fig. 1B). It weighed 2.9 g with dimensions measuring 2.4×2.0×1.5 cm. We submitted the entire specimen for histologic examination.


A ciliated cyst with müllerian differentiation arising in the posterior mediastinum.

Lee SJ, Hwang CS, Park do Y, Huh GY, Lee CH - Korean J Pathol (2014)

(A) Chest magnetic resonance imaging shows a paravertebral cystic mass in the posterior mediastinum (white arrow). The mass has a high intensity signal on T2-weighted image, equal to the signal intensity of water. (B) A resected specimen reveals a thin-walled, translucent unilocular cyst, filled with clear serous fluid.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4215971&req=5

f1-kjpathol-48-5-401: (A) Chest magnetic resonance imaging shows a paravertebral cystic mass in the posterior mediastinum (white arrow). The mass has a high intensity signal on T2-weighted image, equal to the signal intensity of water. (B) A resected specimen reveals a thin-walled, translucent unilocular cyst, filled with clear serous fluid.
Mentions: An abnormal mass lesion in the posterior mediastinum of a 42-year-old woman was found incidentally during a routine medical check-up. Well-defined cystic lesion, measuring about 2.6 cm in diameter, and arising in the right paraspinal mediastinum was noted on magnetic resonance imaging and computed tomography of the chest. The mass exhibited high signal intensity on T1-weighted imaging and low signal intensity on T2-weighted imaging, which suggested that the lesion was purely cystic (Fig. 1A). The differential diagnosis based on radiologic imaging included a bronchogenic cyst or neurogenic tumor with cystic change. She underwent video-assisted thoracoscopic surgery for the excision of the mass. The mass was a unilocular cyst with thin, lucent walls filled with clear serous fluid (Fig. 1B). It weighed 2.9 g with dimensions measuring 2.4×2.0×1.5 cm. We submitted the entire specimen for histologic examination.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Pusan National University School of Medicine, Yangsan, Korea.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

We found a posterior mediastinal cyst with Müllerian differentiation that was consistent with previous description of Hattori’s cyst... To our knowledge, this is the first report of Hattori’s cyst arising in the posterior mediastinum in Korea... An abnormal mass lesion in the posterior mediastinum of a 42-year-old woman was found incidentally during a routine medical check-up... The cystic wall was lined by a simple ciliated cuboidal to columnar epithelium supported by thin connective tissue... Some H-caldesmon positive bundles of smooth muscle cells were found (Fig. 2B)... The epithelium of the papillary structure was composed of ciliated pseudostratified columnar and intercalated clear cells (Fig. 2C)... We did not identify any atypia in the epithelial cells... The pathologic diagnosis was benign ciliated cyst of the posterior mediastinum showing Müllerian differentiation, suggestive of the so-called mediastinal Hattori’s cyst... Thus, because the histogenesis of these structures is still not understood, the descriptive term ‘ciliated cyst with Müllerian differentiation’ may be more appropriate for the designation of these cysts... Before Hattori suggested Hattori’s cyst as a new disease entity, mediastinal cysts with Müllerian differentiation were misdiagnosed as bronchogenic cysts due to their ciliated epithelium... Compared with bronchogenic cysts, the lining epithelium of cystic structures with Müllerian differentiation do not have cartilage structure and are ER and PR positive... ER, PR, and PAX-8, which show positivity to epithelial cells in the present case, are known to be the best markers of Müllerian cysts... Additionally, the lining epithelial cells of the present case were positive for CK7, and negative for CK5/6 and calretinin, which are specific for mesothelial differentiation.

No MeSH data available.


Related in: MedlinePlus