Rare potential pitfall in endoscopic ultrasound-guided fine needle aspiration biopsy in gastric duplication cyst: a case report

Acta Cytol. 2009 Mar-Apr;53(2):219-22. doi: 10.1159/000325129.

Abstract

Background: Foregut duplication cyst (FDC) is rare in the adult population. It is usually an incidental finding in clinical settings. As endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNAB) becomes a preferred and popular procedure, it is imperative for cytopathologists recognize this rare lesion and avoid the diagnostic pitfall.

Case: A 48-year-old man presented with a 3-cm mass on the lesser curvature of the stomach with regional lymphoadenopathy. EUS-FNAB revealed abundant tenacious, viscous, mucinous material with scattered histiocytes and gastric and esophageal mucosal cells. A mucinous neoplasm was suspected, and partial sleeve gastrectomy was subsequently performed for removal of the gastric mass. The histopathologic finding was characteristic of gastric duplication cyst.

Conclusion: The cytologic features of FDCs may closely resemble those of mucinous neoplasms, especially with clinically elevated carcinogenic embryonic antigen and CA19-9. The abundant mutinous material with scattered mucophages can create a diagnostic challenge and pitfall. Clinical information with endoscopic findings and knowledge of FDC are important for appropriate diagnosis of mucinous lesions.

Publication types

  • Case Reports

MeSH terms

  • Biopsy, Fine-Needle*
  • Cysts / congenital
  • Cysts / diagnostic imaging
  • Cysts / surgery
  • Diagnosis, Differential
  • Endoscopy, Digestive System*
  • Endosonography*
  • Humans
  • Kidney Failure, Chronic / complications
  • Male
  • Middle Aged
  • Stomach Diseases / congenital
  • Stomach Diseases / diagnostic imaging*
  • Stomach Diseases / surgery
  • Stomach Neoplasms / pathology*