Ectopic bronchogenic cyst of gallbladder: an unusual anatomical position

A 42-years-old woman presented with right upper abdominal pain for one week. She denied any previous hypertension, diabetes, hepatitis and history of surgery. On clinical examination, there was only pressure pain in the right upper abdomen. The laboratory tests, such as routine blood, liver function and electrolytes, were all within normal reference ranges. A computed tomography (CT) scan showed a cystic occupying lesion over the gallbladder measuring approximately 3.1 cm x 2.7 cm, considering a gallbladder diverticulum. A magnetic resonance imaging (MRI) suggested a restricted fluid signal in the gallbladder fossa, measuring approximately 2.9 cm x 2.7 cm (Fig. 1A-C, arrowhead). A magnetic resonance cholangiopancreatography (MRCP) suggested this cystic mass was connected to the cystic duct (Fig. 1D, arrowhead). The patient was scheduled for laparoscopic exploration. During the operation, a cystic mass about 3.0 cm × 2.5 cm near gallbladder fossa was observed. There was no connection between the cyst and the gallbladder. The gallbladder and the entire cyst were removed from the gallbladder bed successively. We opened the wall of the cyst and could see the clear yellowish-brown fluid, different from ordinary bile, gushing out. Histologically, the cyst wall was covered with Postoperative pathological sections showed that the cyst wall was covered with pseudostratified ciliated columnar epithelium (Fig. 1E and F, arrowhead), with mucous glands under the epithelium (Fig. 1E, circle), and the cyst wall contained smooth muscle (Fig. 1E, pentagram), leading to the diagnosis of bronchogenic cyst. No recurrence of the cyst was seen in this patient during the 6 months of follow-up.