General
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• Rare; mostly developmental unless due to cystic degeneration of tumor
• Simple cysts are epithelial lined; duplication cysts have 2 muscle layers (eMedicine, Arch Pathol Lab Med 1977;101:136)
• Either intramural or attached to outer layers of esophagus
• Often asymptomatic, even if large; may cause obstructive symptoms
• See also retention cysts

General
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• Often young women with dysphagia or chest pain during exercise (Clin Imaging 2006;30:309)
• Developmental cysts arise from anomalous budding of foregut bronchial structures; contains cartilage and mucus glands, smooth muscle and ciliated columnar epithelium

Case reports
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• 26 year old man with cystic lesion at lower esophagus (Dig Surg 2006;23:209)

Micro images
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Cyst lined by respiratory epithelium

General
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• Also called gastroenteric cyst, foregut cyst
• Congenital anomaly, usually lower esophagus
• Most are intramural; usually isolated anomaly; however, duplications external to esophageal wall may be associated with vertebral anomalies
• 90% do not communicate with esophagus
• Usually symptomatic causing dysphagia or respiratory difficulty

Case reports
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• 22 day old boy (Indian J Pathol Microbiol 2006;49:396)
• 2 infants with respiratory distress (Pediatr Emerg Care 2005;21:854)
• 14 year old boy with fistula to lung (Eur J Cardiothorac Surg 2000;18:117)
• 52 year old woman (Yonsei Med J 2005;46:859)
• 61 year old woman with squamous cell carcinoma (Br J Radiol 2003;76:343)

Treatment
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• Surgery (if symptoms) or possibly observation (Endoscopy 2005;37:870)

Clinical images
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Defect of the muscular layer

Micro description
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• Mucosa, submucosa and muscular layers similar to GI tract; lined by either esophageal squamous, gastric, primitive, ciliated columnar or small intestinal epithelium

Micro images
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Cyst wall

Squamous cell carcinoma

General
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• Lined by squamocolumnar epithelium, may be ciliated

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