Cyst of Hattori: literature review and case presentation

The cyst of Hattori is a rare pathology occurring only in women. Only about 45 – 50 cases have been described in literature up until now. All cases were reported in foreign sources, there were no reports in Russian-speaking media. The etiology of disease is still unknown, however the disorder of Mullerian duct development (embryonal anlage of female reproductive system) was suggested as the cause. X-ray imaging of the cyst of Hattori is very nonspecific. The cyst should be differentiated with pleural tumors, lung tumors, bronchogenic and celomic mediastinal cysts. The diagnosis is verified by histology augmented with immunohistochemistry assays of the surgical sample.

The aim of the review was to inform the pulmonologists, general practitioners, infectious disease specialists, thoracic surgeons, oncologists and gynecologists about the cyst of posterior mediastinum that develops from the remnants of Mullerian duct, about its diagnosis, clinical course, and treatment. Also we present one clinical case of patient with Hattori’s cyst.

Conclusion. The cyst of Hattori is very rare in clinical practice. However, physicians should know about it and include it into differential diagnosis when rounded shadows are identified in mediastimun by chest X-ray. The development of the disease is related to the embryonal disorders of Mullerian duct formation. Not only the light microscopy, but also immunohistochemical assays are necessary for the morphological confirmation of the diagnosis. The specific feature of cyst of Hattori is positive staining for the estrogen and progesterone receptors of the cells lining the cyst. Surgical excision is recommended for diagnosis, to improve the symptoms, and to exclude potential origin of the malignant transformation in the embryonal tissues of Mullerian duct. A forecast for the cyst of Hattori is favorable.

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