digestive cystic lesions

Cystic lesions of the gastrointestinal (GI) tract rarely occur and often demonstrate various pathologic findings.

These lesions can be divided into several categories:
 congenital lesions,
 neoplastic lesions,
 miscellaneous lesions.

Most of the cystic masses of the GI tract are discovered incidentally and usually appear as submucosal lesions. Patients can present with a variety of symptoms, including abdominal pain, bowel obstruction, perforation, intussusception, intestinal bleeding, and associated malignancy.

Histologically, most of the cystic lesions of the GI tract are benign; however, some represent cystic changes in malignant tumors or potentially malignant.

A number of imaging modalities, such as plain abdominal radiograph, barium study, transabdominal ultrasonography (US), computed tomography (CT), and magnetic resonance (MR) imaging, have been used to differentiate among cystic lesions.

Although the roles of radiologic imaging modalities are limited due to a substantial overlap in radiologic findings, some cystic lesions have predominant or specific radiologic features. When these features are coupled with the anatomic location of a lesion, a correct diagnosis can often be inferred.

Classification of Cystic Lesions of Gastrointestinal Tract

 Lesions and Preferential Locations

• CONGENITAL LESIONS
  • Duplication cyst ileum, esophagus, colon
  • Heterotopic pancreas stomach (usually antrum), duodenum Tailgut cyst retrorectal/presacral space

• NEOPLASTIC LESIONS
  • Cystic Neoplasms
    • Lymphangioma colon, duodenum
    • Teratoma cecum, rectosigmoid colon

• • Cystic Degeneration of Solid Neoplasms
    • Schwannoma stomach
    • Gastrointestinal stromal tumor stomach, small bowel
    • Adenocarcinoma colon, rectum

 MISCELLANEOUS LESIONS

• Brunner’s gland hyperplasia duodenum
• Gastritis cystica profunda stomach (body and antrum)
• Colitis cystica profunda rectum, sigmoid colon
• Intramural pseudocyst duodenum (second portion)

References

 Cystic Lesions of the Gastrointestinal
Tract: http://synapse.koreamed.org/Synapse/Data/PDFData/0068KJR/kjr-11-457.pdf