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PubMedDate not supplied

[Imaging of bronchogenic cysts].

Bronchogenic cysts, unlike the other mediastinal cysts, exhibit a high incidence of complications, which makes their resection advisable even if no symptoms are present. The correct diagnosis should thus be made with the available imaging modalities. We reviewed our series of 11 bronchogenic cysts, all of them studied with conventional radiology (CR), as well as with such newer imaging modalities as CT and/or MRI. All mediastinal lesions had fluid density at CT and were homogeneously hyperintense on T2-weighted MR images. On the contrary, on T1-weighted images, some lesions were hypointense and some hyperintense, probably because of their rich protein content. In contrast, hilar or pulmonary lesions had air inside, except for one case--characterized by multiple localizations--in which the hilar lesion exhibited the same fluid density as the mediastinal lesions. The CT or MR finding of a lesion with fluid content below the carina permits a nearly unquestionable diagnosis of bronchogenic cyst since the other cystic lesions involve this region very rarely. In all the other cases, other types of mediastinal or hilar-pulmonary lesions cannot be ruled out. In particular, in case of cysts in paraesophageal site, no imaging modality permits to differentiate bronchogenic from enteric cysts; in some cases, the differential diagnosis may be impossible even with histology of the resected specimen.

Adolescent↗
PubMed1995

Pedicled pericardial patch repair of a carinal bronchogenic cyst.

Bronchogenic cysts should be completely removed. Small communications with the tracheobronchial tree occur, but extensive involvement is rare. A case of bronchogenic cyst replacing the carina and the medial wall of the right and left main bronchi is presented. Resection and reconstruction was accomplished by using a pedicled pericardial patch to close the defect created by removal of the bronchogenic cyst. Follow-up at 2 years shows an excellent result.

Bronchogenic Cyst↗
PubMed1994

Hemodynamic compromise secondary to a mediastinal bronchogenic cyst.

Bronchogenic cysts are not commonly the cause of severe symptoms, and often present only as an abnormality on chest roentgenogram. We report an unusual patient with a mediastinal bronchogenic cyst associated with rapid hemodynamic deterioration secondary to compression of vital structures.

Adult↗
PubMed1988

[Pulmonary and mediastinal bronchogenic cysts].

Bronchogenic cysts are relatively rare anomalies with a congenital origin resulting in an abnormal branching of the tracheo-bronchial tree. They either develop in the pulmonary parenchyma or in the mediastinal region. Between 1975 and 1987, 21 cases of bronchogenic cysts were operated upon. Eighteen of these cysts had a pulmonary localisation and 3 were mediastinal. Only 8 of these were diagnosed pre-operatively by bronchoscopy. The major reason for delay in diagnosis is persistent or recurrent pulmonary infection. Eight cases were treated by cystectomy, 4 by simple wedge resection, 4 by segmental resection, 3 were extirpated and 2 by lobectomy.

Adolescent↗
PubMed1989

Bronchogenic cysts.

Bronchogenic cysts are relatively uncommon congenital lesions. They may be detected on routine radiography in asymptomatic patients or may present with various manifestations, some of which may be life-threatening. Age at diagnosis ranges from infancy to late adulthood, with asymptomatic lesions occurring more often in older children and adults. Cysts may be located in subcarinal, paratracheal, hilar, paraesophageal and intrapulmonary sites. The chest radiograph is the primary diagnostic study, with computed tomographic scans of the chest providing more definitive evaluation. Despite some controversy, surgery is considered the treatment of choice, even in the asymptomatic patient.

Bronchogenic Cyst↗
PubMed1997

[Thymic cyst resembling a bronchogenic cyst].

Bronchogenic cysts are common cystic lesions in the mediastinum. Most are located in the middle or posterior ares of the mediastinum, especially around the carina. We encountered a patient with a mass in the superior and anterior areas of the mediastinum, where bronchogenic cysts are not usually found. The mass was therefore, thought to be a thymic cyst. The cyst was located just behind the sternum and in front of the left brachio-cephalic vein, and was 5.5 x 3.5 x 1.2 cm. It originated in the upper and median part of the thymus, and was not attached to the respiratory tract. Histological examination showed ciliacted epithelium and a layer of smooth muscle in the wall of the cyst. The cyst contained viscid, yellowish, turbid fluid. Preoperative computed tomography and magnetic resonance imaging showed findings characteristic of bronchogenic cysts, except for the location. We know of no previous reported case of a thymic cyst resembling a bronchogenic cyst.

Bronchogenic Cyst↗
PubMed1984

[Bronchogenic cysts and their atypical localizations. A case of pleuro-diaphragmatic cyst].

Bronchogenic cysts represent about 10 p. 100 of all surgical tumours of the mediastinum. They can never be diagnosed with absolute certainty prior to the operation, but when they arise in their typical sites, they can be suspected with a high probability. However, they can occur in very atypical sites, in which case the diagnosis remains very hypothetical until the operation. The authors report a case of a cyst which developed under the diaphragmatic pleura, in direct contact with the dome of the diaphragm and attached to the mediastinum by a fine vascular pedicle which inserted in the root of the triangular ligament.

Adult↗
PubMed1997

[A variety of mediastinal bronchogenic cyst: the broncho-alveolar cyst].

Congenital bronchogenic cysts are usually located in the mediastinum or develop as intrapulmonary cysts. Gross examination of excised bronchogenic cysts shows them to be unilocular; histologically, these lesions are characterized by the presence of respiratory-type pseudostratified epithelium as well as small islands of cartilage and seromucinous glands. We report a case of a mediastinal bronchogenic cyst having pulmonary parenchyma within the cyst wall. The rarity of our case, the pathological and clinical features and the embryological development of bronchogenic cysts are briefly discussed.

Adult↗
PubMed1991

[Two successful cases of paraesophageal bronchogenic cysts].

Paraesophageal bronchogenic cyst is a rare disease. Only 24 cases have been previously reported in Japan. Recently, we experienced two successful cases of this disease. Two cases (64-year-old man and 31-year-old man) were both asymptomatic and pointed out by chance on the chest X-ray at the left posterior mediastinum. The second case was an intramural esophageal cyst. Microscopic examination showed the typical findings of the bronchogenic cyst, as the inner wall of the cyst was covered with ciliated columnar epithelium and the wall consisted of cartilage, mucous glands and smooth muscle. Both postoperative courses were uneventful. Resection was recommended because of the symptoms due to the compression of the cyst and the possibility of malignancy.

Bronchogenic Cyst↗
PubMed1991

Pseudoadrenal mass: unusual presentation of bronchogenic cyst.

Isolated abdominal bronchogenic cysts are extremely rare. We report the fourth such case in an asymptomatic 4-year-old girl who initially presented for evaluation of urinary tract infection and new-onset urinary incontinence. Ultrasound, computed tomography, and magnetic resonance imaging findings were consistent with an adrenal mass. At exploration, the patient was found to have a mass in the area of the gastroesophageal junction and a normal left adrenal gland. The final pathology confirmed the diagnosis of a bronchogenic cyst. Abdominal bronchogenic cysts, although rare, should be considered in the diagnosis of a retroperitoneal mass.

Abdomen↗
PubMed1993

[Thirty-eight operative cases of mediastinal cyst: with particular reference to bronchogenic cyst].

Thirty-eight patients (16 males and 22 females) with mediastinal cysts have been treated at the Second Department of Surgery at Okayama University from 1978 to 1989. There were thirteen cases of thymic cyst, nine cases of pericardial cyst one case of pericardial diverticulum, eight cases of bronchogenic cyst, two cases of dermoid cyst, two cases of cystic lymphangioma, one case of esophageal cyst, one case of gastroenteric cyst, and one case of aneurysmal bone cyst. MRI seemed to be useful for the qualitative diagnosis of mediastinal tumors as cystic or solid. Based on Maier's classification and considering the result of this study, bronchogenic cysts may be divided into the following groups: 1) paratracheal, 2) carinal, 3) hilar, 4) paraesophageal [a) upper (Iu), b) lower (Im, Ei)], 5) cephalad recess of the azygos vein (CRAzV) and 6) miscellaneous. According to this new classification, these bronchogenic cysts could be allocated to (3) hilar: 1 cyst, (4-a) paraesophageal-upper: 1 cyst, (4-b) paraesophageal-lower: 1 cyst, (5) CRAzV: 4 cysts, and (6) miscellaneous: 2 cysts.

Adolescent↗
PubMed1993

[Thoracoscopic treatment of bronchogenic cyst].

A central bronchogenic cyst was excised thoracoscopically from a 44-year-old woman in whom a tumor had been pointed out in the left upper posterior mediastinum at a screening examination. Since the tumor was diagnosed to be benign, only conservative follow-up was undertaken, but the patient consulted our department desiring active therapy. On the basis of the chest CT and MRI findings a bronchogenic cyst was diagnosed. Under general anesthesia and mechanical ventilation of one lung, the thoracoscope was inserted into the thoracic cavity revealing in the left upper posterior mediastinum a cyst which was excised thoracoscopically. While coagulation was performed gingerly with an electric scalpel, the tumor was detached sharply and bluntly with a pair of scissors. The postoperative course was uneventful with little wound pain or scar formation. Hitherto bronchogenic cysts have been treated by resection after thoracotomy. Although this is an easy procedure, a relatively large operative scar is left and considerable wound pain may develop. In contrast, thoracoscopic treatment is characterized by minimal surgical invasiveness, little postoperative wound pain, and small scars. These advantages suggest that this technique may be indicated for benign mediastinal tumors, particularly cysts.

Adult↗
PubMed1994

Presentation and management of bronchogenic cysts in the adult.

Bronchogenic cysts are congenital anomalies of the bronchial tree that are often asymptomatic at presentation in adults. Management of asymptomatic bronchogenic cyst in this population remains controversial. Eighteen patients with bronchogenic cysts were treated at our institution since 1975. At initial presentation, 10 patients (56 percent) were asymptomatic and 8 (44 percent) were symptomatic. Cough and pain were the most frequent symptoms. Two patients presented with potentially serious complications, one with respiratory distress from airway compression and the other with infection and airway fistulae. Chest radiographs were abnormal but nondiagnostic in 17 out of 18 (94 percent) patients. Chest computerized tomography (CT) scans were abnormal in eight of eight (100 percent) patients, but they confirmed the benign cystic nature in only five of eight (62.5 percent). Overall, considering the use of all imaging modalities and clinical suspicion, bronchogenic cyst was considered in the preoperative differential diagnosis in only 11 of 18 (61 percent) patients. Fifteen of 18 cysts were resected initially. Three of the asymptomatic patients who were followed up initially ultimately required resection because of the development of symptoms. A trend toward increased postoperative complications was noted in patients who were symptomatic at the time of surgery (27 percent vs 14 percent). In conclusion, adult patients with asymptomatic bronchogenic cyst may develop symptoms over time. Symptoms in adults can sometimes be potentially serious. Since a confident preoperative diagnosis is not always possible and because surgical complications may be more common in the symptomatic patient, we recommend surgical resection of all suspected bronchogenic cysts in operable candidates.

Adolescent↗
PubMed1982

Intraparenchymal bronchogenic cysts in adults.

Bronchogenic cysts are uncommonly diagnosed in adults. Herein presented are 4 such cysts of the intaparenchymal variety which occurred in 3 adult Nigerians. The salient features illustrating the nuances and variations of their presentation in accordance with their location within the lungs are discussed in the context of the congenital origin of the cysts. The etiology is reviewed and the difficulties in diagnosis are discussed as well as the acceptability of the bronchogenic cyst as a differential diagnosis of common cystic pulmonary pathologies, especially if solitary, in adults.

Adult↗
PubMed1995

[Recurrent bronchogenic cyst--a case report].

Mediastinal bronchogenic cyst is a benign tumor and occupied about 5% of mediastinal tumor in Japan. As a benign tumor, recurrence of bronchogenic cyst is very rare, and we found only 2 cases were reported. We experienced a recurrent bronchogenic cyst found 14 years after first operation. The patient was 56-year-old male, and admitted to our hospital for further evaluation of his abnormal shadow on chest roentogenogram. He had no symptoms. He was operated an bronchogenic cyst for 14 years ago. Chest X-ray, CT, and MRI demonstrated a paratracheal cystic mass which was suspected of a recurrent bronchogenic cyst. An operation was done, and the tumor was resected. A histopathological study showed that the tumor had thin wall and had a ciliated epithelium, then it was diagnosed bronchogenic cyst. The most likely explanation for the recurrence in our patient is an incomplete resection during the initial operation. It is though that only a very small amount of epithelial tissue need remain for recurrence. For prevention of recurrence, complete resection of cyst is necessary, and long-term follow-up is indicated to detect recurrence.

Bronchogenic Cyst↗
PubMed1990

Bronchogenic cyst with tracheal involvement.

Bronchogenic cysts are uncommon developmental anomalies of the primitive foregut that can produce symptoms of ventilatory compromise in infants and children. A 2-month-old child presented with episodes of stridor and obstructive apnea due to a bronchogenic cyst compressing the trachea and causing near-total obstruction. Aspiration of the cyst during bronchoscopy resulted in severe bradycardia (from 140 to 50 beats per minute), although blood pressure was stable and oxygen saturation remained at 100%. Subsequent elective thoracotomy revealed the cyst to be intimately associated with the vagus nerve, and vagal stimulation may have caused the bradycardia. Bronchogenic cysts, although rare, should be considered in the differential diagnosis of infants and children undergoing direct laryngoscopy and bronchoscopy for airway compromise. The endoscopic aspiration of cystic tracheal and bronchial lesions may not obviate the need for more definitive surgical treatment and, as this case demonstrates, is not free of potential hazard.

Bradycardia↗