title: Metabolite signature of developmental foregut cyst on in vivo and in vitro (1)H MR spectroscopy.
abstract: Foregut duplication cysts are developmental anomalies of the bronchopulmonary foregut and are common cystic lesions of the mediastinum. We describe a case of mediastinal foregut duplication cyst with in vivo (1)H MR spectroscopy on a 1.5T magnet showing a large metabolite peak at 2.02 ppm, attributable to N-acetylated compounds, in addition to a smaller peak at 1.33 ppm, considered to represent lipids. In vitro NMR spectroscopy (7.05T) of cyst fluid confirmed the presence of these peaks. In addition, a broad multiplet centered at 3.7 ppm, possibly from various protons of the hexose ring system, was also noted. Chemical analysis of the cyst fluid demonstrated the presence of N-acetylhexosamines, proteins, and lipids. Again, in vitro spectra of pure samples of N-acetylglucosamine and N-acetylgalactosamine were obtained for comparison, which better resolved the N-acetyl peak and the peaks at 3.7 ppm. The mucus secreted by respiratory epithelium and the mucous glands of the foregut cysts contains glycoproteins that have N-acetylhexosamines as components and lipid breakdown products that are thought to contribute to the observed spectrum. This information might be useful in predicting the cyst content and, in turn, the lining of the epithelium and the glandular elements.
authors.affiliation: Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Science and Technology, Trivandrum, Kerala, India.
authors.forename: Kannath
authors.initials: K
authors.lastname: Santhosh
authors.forename: Bejoy
authors.initials: B
authors.lastname: Thomas
authors.forename: Luxmi
authors.initials: L
authors.lastname: Varma
authors.forename: S
authors.initials: S
authors.lastname: Sandhyamany
authors.forename: Chandrasekharan
authors.initials: C
authors.lastname: Kesavadas
authors.forename: P S
authors.initials: PS
authors.lastname: Appukuttan
authors.forename: G
authors.initials: G
authors.lastname: Srinivas
authors.forename: Arun Kumar
authors.initials: AK
authors.lastname: Gupta
authors.forename: T R
authors.initials: TR
authors.lastname: Kapilamoorthy
authors.forename: M
authors.initials: M
authors.lastname: Unnikrishnan
mesh_terms: D000328:Adult; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008476:Mediastinal Cyst / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D010784:Photomicrography