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November 2002, Vol 128, No. 11 >

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Clinical Note | November 2002

Neonatal Lingual Choristoma With Respiratory and Gastric Epithelium

David L. Mandell, MD; Sarangarajan Ranganathan, MD; Charles D. Bluestone, MD
Arch Otolaryngol Head Neck Surg. 2002;128(11):1321-1324. doi:10.1001/archotol.128.11.1321.
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Lingual choristomas are rare entities that typically present as benign cystic masses that are lined with a variety of heterotopic epithelia. Lingual choristomas that are lined with respiratory and/or gastric or intestinal mucosa are believed to derive from pluripotential cells of the embryonic foregut. We describe a neonate with a lingual cyst that was lined predominantly by respiratory epithelium and focally by gastric foveolar epithelium, and we review the terminology, etiology, and management of lingual cysts of presumed foregut origin.
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Figure 1.

Axial computed tomographic scan of oral cavity with intravenous contrast showing a 3 × 4-cm cystic, thick-walled, rim-enhancing mass involving the floor of the mouth and the ventral portion of the tongue.

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Figure 2.

A, Intraoral examination reveals a mass limited to the ventral portion of the anterior tongue ara. B, After unroofing and marsupialization of the cyst. The long black arrow indicates the mucosa of the ventral portion of the anterior tongue area (retracted superiorly); white arrow, residual cyst lining; and short black arrow, cut edge of tongue musculature.

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Figure 3.

High magnification of the cyst wall showing ciliated pseudostratified columnar epithelium (arrow) (A) and a focus of gastric foveolar epithelium (arrow) with adjacent respiratory-type epithelium (B) (hematoxylin-eosin, original magnification ×400).

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Figure 4.

Appearance of tongue 6 months after surgery.

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