Bronchogenic Cyst

Question 1

What is a bronchogenic cyst

Answer 1

A developmental cyst arising from the trachea or a bronchus

They result from an abnormal budding of the tracheobronchial tree.

Question 2

Walls of bronchogenic cyst contains

Answer 2

contains cartilage, smooth muscles, fibrous tissues, and sometimes seromucinous glands.

lined by columnar ciliated epithelium,

Question 3

Potential locations of the bronchogenic cyst include

Answer 3

the cervical or thoracic trachea, the hilar bronchi, or the more distal intraparenchymal bronchi , mediastinum , intra pulmonary cyst

Question 4

Unusual locations of the bronchogenic cysts may include

Answer 4

Inter-atrial septum.

− Neck.

− Esophageal wall.

− Intrapericardial.

− Abdomen.

− Cutaneous and subcutaneous tissues.

− Scapular region.

− Retroperitoneal space.

− Bronchogenic cysts have also been reported to extend from the mediastinum through the diaphragm into the abdomen as dumbbell cysts.

Question 5

Clinical manifestations

Answer 5

No clinical presentation is specifically suggestive of bronchogenic cyst because these lesions are frequently asymptomatic.

• They are usually discovered incidentally on chest x-ray. This is specially so for mediastinal bronchogenic cysts.

• The intrapulmonary cysts may have communication with the airway and become infected and are therefore more often symptomatic.
• In infants, the initial presentation may be respiratory distress
• The diagnosis of bronchogenic cyst should be considered in patients with recurrent chest infections.
• Chest pain, cough, dyspnea, and dysphagia are possible clinical manifestations of bronchogenic cyst.
• These result from compression of the esophagus and/or major airways by the adjacent bronchogenic cyst.
• Bronchogenic cysts located within the abdomen may also produce symptoms because of infection or compression of adjacent structures and hemorrhage has been reported in cysts with ectopic gastric mucosa.

Question 6

Diagnostics

Answer 6

Prenatal ultrasound
Chest X-ray
CT Scan
MRI

Question 7

What are the Chest X-ray findings in bronchogenic cysts ?

Answer 7

sharply demarcated spherical mass of variable size.

When the cyst communicates with the tracheobronchial tree, an air–fluid level may be seen within the cyst

Question 8

CT scan and MRIfinding

Answer 8

CT
Bronchogenic cyst appear as cysts with smooth borders and thin walls and may contain secretions, pus, air, or rarely blood.

Magnetic resonance imaging (MRI):

− This usually shows a homogeneous cyst of moderate-to-bright intensity on T2-weighted

Question 9

Treatment of bronchogenic cyst

Answer 9

Surgical resection of all suspected cyst

• Treatment consists of complete surgical resection. This can be accomplished by a posterolateral thoracotomy, thoracoscopy, and at times a median sternotomy may be required
• In patients with intrapulmonary bronchogenic cysts, lobectomy may be necessary
• Palliative procedures such as mediastinal puncture and aspiration can be considered in symptomatic patients who are not fit to undergo complete resection.