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[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↗

Congenital cervical bronchogenic cyst.

A bronchogenic cyst is a rare developmental aberration that occurs in the paediatric age group. Over 50 cases of bronchogenic cysts have been reported in the literature. There is still a possibility of clinically misdiagnosing this condition as a more common congenital neck cyst like a branchial cyst. We report here the case of a 12-year-old female presenting with a neck swelling since birth who was diagnosed to have a bronchogenic cyst based on characteristic clinical and histopathological findings.

Bronchogenic Cyst↗

Paraesophageal bronchogenic cyst associated with multiple epithelial splenic cysts.

BACKGROUND: Bronchogenic cysts are rare congenital cystic lesions of foregut origin. They are the result of abnormal budding of the primitive tracheobronchial tube. Nonparasitic, true splenic cysts are another rare entity that might occur as incidental findings but may lead to deleterious courses in case of ruptures. CASE REPORT: We report here the first case of the uncommon association of a paraesophageal bronchogenic cyst and multiple primary splenic cysts in a 23-year-old woman suffering from dysphagia and chest pain. Successful complete resection of the paraesophageal cyst was performed using an abdominal, transhiatal approach and splenic cysts were subjected to organ-preserving TA stapler resection. CONCLUSION: Thus far there is no proof or genetic indication for a direct association of bronchogenic cysts and multiple splenic cysts, however, the uncommon coincidence of both lesions in our patient might suggest a common origin. Difficulties in preoperative diagnosis, histopathological characteristics and surgical treatment modalities are presented.

Adult↗

[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↗

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↗

[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↗

[Laparoscopic extirpation of retroperitoneal bronchogenic cyst].

The retroperitoneal bronchogenic cyst is an extremely rare anomaly. During the examination of an 18-year-old female patient due to her extreme thinness, the abdominal ultrasound and later the CT indicated as an accidental finding--a left side adrenal/suprarenal adenoma, which turned out to be hormonally inactive. But while we were doing a laparoscopic surgical intervention we found a 6-8-cm cyst in the retroperitoneum, between the greater curvature and the spleen. It contained light grey, mucinous liquid. The left suprarenal gland had normal size and appearance. During the microscopic examination the removed terime showed cystic structures, which were covered inside with multilayer ciliated columnar epithelium, mucous excretory glands, a whole layer of connective/interstitial and smooth muscle tissue. Neither cartilage, nor gastrointestinal epithelium was found. Only a few publications have reported about retroperitoneal bronchogenic cyst so far. These lesions occur very rarely at the greater curvature. Although this alteration is really unusual, bronchogenic cysts have to be expected in the differential diagnostics of the retroperitoneal tumors.

Adolescent↗

[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↗

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↗

[Bronchogenic cysts: Radiologic findings].

Bronchogenic cysts are congenital anomalies that result from abnormal budding of the tracheobronchial tree. They are usually found in the mediastinum around the tracheobronchial tree or in the lung parenchyma. Although they can occur in infants and children, they are frequently detected coincidentally in the third and fourth decades. Their radiological findings can change according to their locations. In this pictorial assay we reviewed the radiological appearance of bronchogenic cysts with different imaging modalities.

Bronchogenic Cyst↗

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↗

[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↗

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↗

Bronchogenic cysts of the neck in adults.

Bronchogenic cysts are congenital sacs that result from maldevelopment of the primitive foregut. Although they occur predominantly in the chest, there are reports of lesions in extrathoracic locations. The majority of reported bronchogenic cysts located in the neck are found in the pediatric population; a review of the literature reveals few reports of bronchogenic cysts of the neck among adults. The diagnosis of a bronchogenic cyst relies on the histology and location of the lesion. Here, we review our experience in the diagnosis and management of 2 adult patients with pathologically proven bronchogenic cysts. Both patients presented with solitary neck masses that proved to be bronchogenic cysts on histologic examination. Our purpose is to define the histopathologic and clinical characteristics of bronchogenic cysts and discuss the features that distinguish them from other cervical cysts. In conclusion, congenital bronchogenic cysts can occur in the neck of adults and should be considered in the differential diagnosis of cystic cervical masses in adults, as well as children.

Adult↗

Retroperitoneal bronchogenic cyst: a case report.

A 46-year-old woman presented with a 1-year history of progressive left-arm numbness. A cyst below the left hemidiaphragm was discovered incidentally when a CT scan was performed to examine the thymus for a suspected tumor. A thymic mass was found. MRI indicated that the cyst contained proteinaceous fluid. The thymoma was approached through a median sternotomy and resected, but the cyst was found to be infradiaphragmatic. A separate, left paraspinal incision was made to access the retroperitoneum, and the cyst was resected. Histologic examination showed that the cyst was bronchogenic in origin. Retroperitoneal bronchogenic cysts are very rare, and only four cases have been reported in the English-language literature.

Bronchogenic Cyst↗

Mediastinal bronchogenic cyst treated by mediastinoscopic drainage.

Bronchogenic cysts are rare congenital anomalies located in the mediastinum and lung parenchyma. We present the clinical findings and describe the mediastinoscopic treatment of a bronchogenic cyst at the subcarinal space in a 50-year-old man. CT revealed a lesion at the subcarinal space with soft tissue density. Initially, mediastinoscopy was performed for diagnostic purposes. Histopathological evaluation of biopsy material taken from the cyst wall confirmed that the lesion was a bronchogenic cyst. The cyst contents were drained and a sclerosant agent was applied to the cyst lumen via the drainage tube. Mediastinoscopy not only provides diagnostic information but can also be used safely in the treatment of anterior bronchogenic cysts in patients not amenable to a second operation.

Bronchogenic Cyst↗