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Background: Bronchogenic cysts result from a congenital anomalous budding of the tracheobronchial tree. Resection is usually recommended to avoid complications. Mediastinal bronchogenic cysts present a unique challenge due to their proximity to vital structures. The purpose of this study is to review our experience with mediastinal bronchogenic cysts. Methods: A single-institution retrospective review evaluated all mediastinal bronchogenic cyst excisions between January 2012 and November 2022. Patient demographics were assessed, including age at diagnosis, presenting symptoms, imaging workup, and cyst characteristics. Operative approach, complications, and surgical pathology were reported. Results: Five patients were identified. Age at diagnosis ranged from 18 to 27 months. No patient was diagnosed prenatally. All patients had symptoms at the time of diagnosis, including cough, wheezing, and respiratory distress. Three cysts were paratracheal, and two were paraesophageal. Age at surgery ranged from 26 to 30 months. All bronchogenic cysts were successfully resected thoracoscopically. Individual technical challenges included narrowing of the mainstem bronchus preventing lung isolation, significant mediastinal inflammation, the necessity for cyst evacuation to delineate the extent of the cyst, adherence of cyst wall to bronchus or trachea requiring cold dissection, and a stalk of tissue with an intimate connection to the carina that was amputated. No intraoperative or postoperative complication occurred. Surgical pathology was consistent with a bronchogenic cyst in all cases. Median length of hospital stay was two days. Conclusion: Thoracoscopy is a safe and effective procedure for mediastinal bronchogenic cyst excision in children. Certain technical maneuvers are highlighted, which may facilitate resection. [ABSTRACT FROM AUTHOR]

The bronchogenic cyst is a class of lung malformations that are congenital and non-vascular. Surgical excision per se is a great challenge for anesthesiologists as there have been cases with complications of fatal tension pneumothorax. Our patient is an 11-month-old child who underwent surgical excision of the bronchogenic cyst compressing the left bronchus. Intraoperatively, due to positive pressure ventilation, tension pneumothorax developed, ultimately leading to cardiac arrest. Prompt treatment with cardiopulmonary resuscitation followed by needle insertion in the second intercostal space on the right side, followed by an intercostal drain, revivedthe patient. An early diagnosis and an adequate approach to possible complications is the key to successful anesthetic management.

Background and aims: Bronchogenic cysts are rare mediastinal tumors caused by foregut malformations. Although surgery remains the definitive form of diagnosis and treatment, we can reach a diagnosis by imaging modalities. This retrospective study aims to analyze our experience with bronchogenic cysts and present a discussion of the demographics of patients, patient signs and symptoms, and cyst complications, as well as a surgical approach for resection and surgical outcomes for patients described in this study. Methods: This retrospective, descriptive cross-sectional study reviewed the medical records of 12 patients who were formally diagnosed with bronchogenic cysts by histopathology and treated surgically between 2010 and 2020. We reviewed the medical records of all patients, including age, location of the cyst, symptoms, complications, imaging techniques, and surgical interventions. Results: In total, twelve bronchogenic cyst cases were included. Eight mediastinal cysts (two intrathymic) and four intraparenchymal cysts. One patient was asymptomatic, and the remaining 11 were symptomatic. The most common symptoms were chest pain, dyspnea, and cough. Four cases suffered from severe bronchogenic cyst complications, of which three had pneumonia and one atelectasis. The longest axis of a bronchogenic cyst ranged from 2–11cm (mean = 4.52cm). All 12 patients underwent complete surgical resection of the cyst without postoperative complications or recurrence. Conclusion: Although bronchogenic cysts are rare, they should be considered in the differential diagnosis of diagnosing mediastinal tumors. In both symptomatic and asymptomatic cases, complete surgical resection is the best option to prevent future recurrence and complications, such as malignancy. [ABSTRACT FROM AUTHOR]

The bronchogenic cyst is a class of lung malformations that are congenital and non-vascular. Surgical excision per se is a great challenge for anesthesiologists as there have been cases with complications of fatal tension pneumothorax. Our patient is an 11-month-old child who underwent surgical excision of the bronchogenic cyst compressing the left bronchus. Intraoperatively, due to positive pressure ventilation, tension pneumothorax developed, ultimately leading to cardiac arrest. Prompt treatment with cardiopulmonary resuscitation followed by needle insertion in the second intercostal space on the right side, followed by an intercostal drain, revivedthe patient. An early diagnosis and an adequate approach to possible complications is the key to successful anesthetic management. [ABSTRACT FROM AUTHOR]

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Objective: Bronchogenic cysts are rare congenital abnormalities, and usually asymptomatic until adulthood. We present a fetus prenatally diagnosed with a bronchogenic cyst, experiencing compression symptoms immediately after birth and underwent thoracoscopic surgery at 14 days old. Case report: A 33-year-old primigravida had a suspicion of fetal tracheal cyst. Prenatal ultrasound scan revealed a cyst near the trachea at 23 weeks’ gestation. Fetal MRI defined a cystic lesion in the upper mediastinum, displacing surrounding vessels. A 3,940 g girl was delivered vaginally at 38 weeks' gestation. Shortly after birth, she developed respiratory distress, and imaging revealed a mediastinal cyst compressing the trachea and esophagus. The cyst was successfully removed through video-assisted thoracoscopic surgery at 14 days old, and pathology confirmed it as a bronchogenic cyst. Follow-up images demonstrated well-aerated lungs. At present, this 1-year-old girl develops normally without respiratory symptoms. Conclusion: Early detection in utero, accurate diagnosis, and timely management are crucial for bronchogenic cysts in neonates.

Bronchogenic cyst is a rare congenital anomaly of the formation of the pulmonary germ, a thin–walled formation filled with thick contents, which distinguishes it from aerial bronchial cysts. Clinically, a bronchogenic cyst can manifest itself as obstructive respiratory failure, swallowing disorders, and lead to recurrent purulent-­inflammatory processes. In this article, we present a clinical case of bronchogenic cyst in a newborn child, detected during pregnancy at the 2nd ultrasound screening and successfully operated on as planned. A 5-day-old boy was transferred to a surgical hospital for surgical treatment of cystic formation of the left lung S10 with dimensions 16.0×12.0×15.0 mm; the cyst contents were homogeneous, corresponding to the fluid. Surgical treatment was performed — the formation was separated from the parietal pleura and sent to the pathology department for histological examination. No complications were observed in the postoperative period. The macroscopically studied object was a three-­dimensional formation of gray-red color with a bluish tinge of irregular shape, dull, with a dark red fine sprinkling. A thin-walled cavity filled with cloudy jelly-like contents was determined on the incision. Microscopic description — a cyst lined with ciliated epithelium, partially flattened to cubic due to dystrophic changes, subepithelial islets of mature cartilage tissue and small groups of mucous glands. Thus, a bronchogenic cyst was morphologically verified. Differential diagnosis of bronchogenic cysts from inflammatory lung diseases (tuberculosis, abscess) with untimely diagnosis in the absence of clinical manifestations is practically impossible without histological examination. Therefore, prenatal diagnosis and morphological examination of the surgical material are crucial.

Radioactive iodine therapy and posttreatment scanning are essential components of differentiated thyroid carcinoma treatment and detection of metastatic disease. False-positive results can be seen on an I-131 scan and are important for clinicians to be aware of. Here, we present a case of a 33-year-old female with follicular thyroid carcinoma who was noted to have an area of moderate uptake in the chest on a whole-body scan following remnant ablation with 30 mCi of I-131 (1.11GBq) concerning for a metastatic hilar lymph node. This was determined to be a mediastinal bronchogenic cyst on surgical pathology. It has been previously proposed that the expression of sodium iodide symporters in some bronchogenic cysts could be the mechanism by which iodine uptake is seen within them. We were able to demonstrate positive immunohistochemical staining for both sodium iodide symporter and the associated paired box gene 8 transcription factor in the cyst sample, which supports the proposed theory. [ABSTRACT FROM AUTHOR]

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In this case report, we present an 8-year-old girl who was referred to the ear-nose-throat department of the Antwerp University Hospital because of an asymptomatic midline neck mass. After resection, histopathological examination was characteristic of a bronchogenic cyst. Bronchogenic cysts are rare, congenital anomalies of the tracheobronchial tree caused by aberrant bud formation of the tracheobronchial tree during embryogenic development. They usually have an intrathoracic location, whereas cervical, cutaneous, and subcutaneous cysts are extremely rare. Initial symptoms are respiratory distress, coughing, and bronchopulmonary infections by compression of the tracheobronchial tree. Imaging studies are recommended to determine the mass's tissue characteristics as well as the engagement of surrounding anatomical structures, which is necessary for adequate preoperative planning. However, a definitive diagnosis may be obtained only after surgery through histopathological analysis. [ABSTRACT FROM AUTHOR]

The occurrence of simultaneous extralobar pulmonary sequestration, esophageal duplication, and bronchogenic cysts is relatively low. We report the case of a 9-month-old Chinese child who had a right lung cyst, detected in utero and was closely monitored until birth. At age 9 months, contrast-enhanced computed tomography revealed right mediastinal extralobar pulmonary sequestration and two cysts. The patient did not exhibit any abnormalities. However, the parents were concerned about the disease. Following positive psychological counseling to the parents, surgery was the strong desire. Subsequently, successful thoracoscopic surgery was performed, excising the three lesions. No postoperative complications occurred. Postoperative pathology confirmed extralobar pulmonary sequestration syndrome combined with esophageal duplication and bronchogenic cysts. The patient was followed-up at 1 and 12 months postoperatively and recovered well with no abnormal space occupation. In such cases, preoperative imaging examinations should be carefully performed, and intraoperative exploration should correspond to that before surgery to avoid lesion omission.

The presented case report describes an incredibly rare instance of an intramedullary bronchial cyst located in the thoracic spinal canal on the dorsal side of the spinal cord, which was observed in a patient with chronic myelogenous leukemia. A 29-year-old man presented with back pain for half a month, along with numbness and pain below the chest and ribs for 1 week. Hypersensitivity was present in the inferior plane of the long xiphoid process in the nervous system. Magnetic resonance imaging (MRI) showed intramedullary cystic lesions in the vertebral body plane of the third to the fourth thoracic vertebra. There was no recurrence during the 6-month postoperative follow-up period. The histopathological findings were consistent with bronchogenic cysts. Cystic lesions were eliminated through the posterior median approach. After the cyst ruptured during surgery, gel liquid was seen, and the majority of the cyst walls were removed. One week after the surgery, the hypersensitivity fully subsided. Six months following surgery, an updated MRI revealed no recurrence. Intramedullary bronchogenic cysts on the dorsal side of the thoracic spine are extremely uncommon. Diagnosis requires histopathological evidence, and it is challenging to diagnose before surgery. Prompt surgical resection is recommended in case of positive diagnosis.

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Aim:A variety of developmental abnormalities of the tracheobronchial tree and pulmonary parenchyma are found in the newborn. There is limited data available on their presentation and clinical course from third world countries.Materials and Methods:A retrospective review of the medical records of children with congenital lung malformations was conducted at our tertiary care hospital from June, 2014 to June, 2018.Results:This study included 30 patients with 12 males and 18 females. The mean age at diagnosis was 13 months (range 1 month to 4 years). Congenital pulmonary airway malformation was the most common malformation present in 18 (60%) patients, followed by congenital lobar emphysema in 4 (13.3%), bronchogenic cyst in 3 (10%), bronchopulmonary sequestration in 2 (6.7%), bronchial atresia in 2 (6.7%) and pleuropulmonary blastoma in 1 (3.3%) patient. The most common presentation was recurrent upper respiratory tract infection (53.3%). Lobectomy was the most common surgical procedure performed in 86.6% of the patients, followed by excision of cyst in 10% of the patients. The post-operative complication rate was 30% with an overall survival rate of 93.3%. The average follow-up duration was 9 months.Conclusion:The predominant lung malformation in this study was congenital pulmonary airway malformation. Recurrent respiratory tract infection with or without respiratory distress was the most common mode of presentation. Health education to raise awareness and emphasis on antenatal ultrasonography can avoid inordinate delays in diagnosis and treatment. Surgery is curative with good long-term outcomes.

The bronchogenic cyst (BC) is a type of congenital anomaly that is most usually found in the mediastinum and lung, and rarely in the diaphragm. We report two cases of bronchogenic cysts originating from the left diaphragm. Case 1 involved a 50-year-old man who underwent computed tomography (CT) of the adrenal glands for hypertension, showing left adrenal changes. An adrenal CT at our hospital showed a space-occupying lesion above the left diaphragm. We performed a left-sided thoracotomy in the seventh intercostal space and found that the mass was entirely located in the diaphragm. Case 2 was a 58-year-old woman who underwent chest CT under a standard health check-up, and a subpleural lesion of approximately 4 cm was found in the posterior basal segment of the left inferior lung lobe. During thoracoscopic surgery, the mass was found to originate from the surface of the diaphragm, having no correlation with the lung tissue. The two cases of diaphragmatic bronchogenic cysts were confirmed by surgical pathology. Ectopic bronchogenic cysts arising from the diaphragm are very uncommon, and diaphragmatic bronchogenic cysts typically occur on the left side, in women, and in the angle between the vertebral column and the diaphragm. As far as we know, there are no relevant reports of intradiaphragmatic BCs similar to case 1, which was entirely located within the diaphragm. Most diaphragmatic BCs are located on the surface of the diaphragm and project toward the thoracic or abdominal cavities. Moreover, bilocular diaphragmatic bronchogenic cysts, similar to case 2, have not yet been reported.

Introduction: Our purpose was to review our experience with the fetuses diagnosed prenatally with congenital pulmonary malformations (CPM). Methods: Retrospective study of fetuses prenatally diagnosed with congenital pulmonary airway malformation (CPAM), broncho-pulmonary sequestration (BPS), bronchogenic cyst (BC) by ult-rasonography between September 2020 and December 2022 Results: Sample analysis was based on 34 pregnancies with CPMs. On the basis of prenatal sonographic appearance, CPAM, BPS and BC were identified antenatally in 79.4% (27/34), 14.7% (5/34) and 5.8% (2/34), respectively. Most (76.5%) were isolated, all cases were unilateral (100%) and majority (64.7%) were regressed late antenatally or postnatally with expectant management. Of the 27 fetuses presented with CPAM, postsurgical resection was necessary for 5 cases (18.5%). There was only one case with hydrops and a CPAM volume ratio >1.6 and was managed with thoraco-amniotic shunt prenatally and right lower lobe resection postnatally. Of the 5 fetuses presented with BPS, thoracoscopic excision was necessary for 2 cases. Of the 2 fetuses presented with BC, cyst excision was performed or planned to cases. Conclusion: The results from our center in last two years reflect overall favorable outcomes for all CPMs. The role of ultrasound is cost-effective during perinatal period rather than fetal MRI. [ABSTRACT FROM AUTHOR]

Background: Congenital pulmonary malformations (CPMs) are rare in children. This study aimed to describe the clinical, imaging characteristics, and treatment of patients with this pathology. Methods: We conducted a descriptive and retrospective study with data from patients with CPMs diagnosed at Instituto Nacional de Salud del Niño-Breña (Lima-Peru), from January 2010 to December 2020. We described CPM clinical and imaging characteristics, type and treatment. Results: The sample was formed of 70 patients. The median age was 29 months (range 15 days-14 years) and the male/female ratio was 1.4. The chest tomography found parenchymal involvement in 50 (71.4%) cases and mixed involvement (parenchymal and vascular) in 18 (25.7%) cases. Congenital malformation of the pulmonary airway was present in 39 (55.7%) cases, followed by bronchogenic cyst in 10 (14.3%), intralobar pulmonary sequestration in 9 (12.9%), and extralobar pulmonary sequestration in 7 (10%). Lobectomy was performed in 61 (87.1%) cases, cystectomy in 5 (7.1%), segmentectomy in 2 (2.9%), and embolization in 2 (2.9%). The most frequent post-operative complication was pneumonia, found in 9 (12.9%) cases. The median hospital stay was 26 days. No patient died during hospitalization. Conclusions: In our institution, the most frequent CPM was congenital malformation of the pulmonary airway, and lobectomy was the most frequently performed surgical procedure. CPMs represent a diverse group of disorders of lung development with varied imaging patterns and clinical manifestations. [ABSTRACT FROM AUTHOR]

Mediastinal bronchial cysts (MBCs) are congenital bronchial cysts (CBCs) that mostly occur in the middle and upper mediastinum and rarely in the posterior inferior mediastinum. A case of posterior MBC was reported in a 19-year-old male patient with mediastinal space occupancy on physical examination. Computed tomography (CT) showed an irregular mass near the spine of the posterior inferior mediastinum, which was of mixed density, with nodular calcification at the edge and inside, and no enhancement. Magnetic resonance imaging (MRI) showed heterogeneous hyperintensity on T1-weighted imaging (T1WI) and hyperintensity on T2WI, which were internal to the cord like appearance and showed septation-like hypointensity, mild enhancement of the lesion edge, and septation in the delayed phase after enhancement. The postoperative pathological diagnosis was bronchogenic cyst. In this report retrospectively reviewed the CT and MRI imaging features of this case, as well as those described in the domestic and foreign literature to summarize the imaging findings of atypical bronchocysts in the posterior lower mediastinum to improve the understanding of this disease.

A 32‐year‐old female presented with palpitations and chest discomfort. The patient had a history of pericardiotomy due to pericardial effusion. Multimodal imaging, including echocardiography, cardiac magnetic resonance (CMR), and coronary computed tomography angiography (CCTA) showed a single mass in the pericardium as the cause of the symptoms. Furthermore, its location and potential complications were accurately defined. The patient underwent a successful surgical resection of the pericardial cyst, microscopic histopathological examination was compatible with a bronchogenic cyst, a very rare congenital malformation. The article discusses the rarity of bronchogenic cysts in the pericardium and the importance of accurate diagnosis and appropriate treatment. [ABSTRACT FROM AUTHOR]

Bronchogenic cysts are the most common mediastinal cysts, usually found in the middle or posterior mediastinum. Anterior mediastinal bronchogenic cysts are uncommon, and intrathymic bronchogenic cysts are extremely rare. We present a case of a 57-year-old male with an incidental finding of an anterior mediastinal nodule. The radiologic appearance of the nodule was suggestive of a lymph node or thymoma. It is often quite difficult to delineate radiologically whether these lesions are benign or malignant. Therefore, the patient underwent a robotic thymectomy to rule out malignancy. Histopathologic assessment of the specimen established the extremely rare diagnosis of an intrathymic bronchogenic cyst. As the guidelines for lung cancer screening have been liberalized, the rate of incidentally discovered thymic lesions will increase. Though a rare diagnosis, bronchogenic cysts should be considered in the differential diagnosis of an anterior mediastinal mass. [ABSTRACT FROM AUTHOR]

Bronchogenic cyst is a rare congenital anomaly arising from the ventral bud of the foregut or tracheobronchial tree. It most commonly presents in the mediastinum, with rare ectopic presentation, accounting for 10% to 15% of mediastinal tumors and 50 to 60% of all mediastinal cysts. In this article, we discuss cases of intrathyroidal bronchogenic cyst and subcutaneous bronchogenic cyst. [ABSTRACT FROM AUTHOR]

Aim: A variety of developmental abnormalities of the tracheobronchial tree and pulmonary parenchyma are found in the newborn. There is limited data available on their presentation and clinical course from third world countries. Materials and Methods: A retrospective review of the medical records of children with congenital lung malformations was conducted at our tertiary care hospital from June, 2014 to June, 2018. Results: This study included 30 patients with 12 males and 18 females. The mean age at diagnosis was 13 months (range 1 month to 4 years). Congenital pulmonary airway malformation was the most common malformation present in 18 (60%) patients, followed by congenital lobar emphysema in 4 (13.3%), bronchogenic cyst in 3 (10%), bronchopulmonary sequestration in 2 (6.7%), bronchial atresia in 2 (6.7%) and pleuropulmonary blastoma in 1 (3.3%) patient. The most common presentation was recurrent upper respiratory tract infection (53.3%). Lobectomy was the most common surgical procedure performed in 86.6% of the patients, followed by excision of cyst in 10% of the patients. The post-operative complication rate was 30% with an overall survival rate of 93.3%. The average follow-up duration was 9 months. Conclusion: The predominant lung malformation in this study was congenital pulmonary airway malformation. Recurrent respiratory tract infection with or without respiratory distress was the most common mode of presentation. Health education to raise awareness and emphasis on antenatal ultrasonography can avoid inordinate delays in diagnosis and treatment. Surgery is curative with good long-term outcomes. [ABSTRACT FROM AUTHOR]

Bronchogenic cysts are the most common primary cysts of the mediastinum. Although most are asymptomatic, some bronchogenic cysts cause symptoms such as chest pain and dyspnea. Here, we report a case of bronchogenic cyst that ruptured twice in a short period of time in a patient who presented with sudden back pain. The lesion was apparent on computed tomography (CT) as a mass lesion with heterogeneous and high attenuation in the posterior mediastinal region. CT-guided puncture performed for diagnostic purposes revealed the contents as bloody fluid. The patient suffered chest pain approximately 3 months after the first presentation, and re-growth and re-rupture of the mass was suspected. The lesion was surgically resected and pathologically diagnosed as a bronchogenic cyst. Spontaneous rupture is a very rare complication of bronchogenic cyst, usually into the trachea, pleural cavity, or pericardial cavity. However, there are no reports of multiple ruptures. This case highlights the importance of recognizing the atypical imaging findings of bronchogenic cyst and the rare complication of rupture.

Bronchogenic cyst is a congenital disease, which is rarely derived from the diaphragm. In this article, one case of bronchogenic cyst of the diaphragm misdiagnosed as pulmonary cyst was reported. A 46-year-old female patient was admitted to our hospital due to intrathoracic mass detected by chest CT. Combined with MRI results, she was diagnosed with the right lower pulmonary cyst before operation. After eliminating surgical contraindications, the cyst was removed under thoracoscope. Intraoperatively, it was found that the cyst originated from the diaphragm, which had a clear boundary with the right lower lung tissues. The diagnosis of bronchogenic cyst of the diaphragm was confirmed by pathological examination. Physical conditions of the patient were stable during postoperative 6-month follow-up.

Abstract Background Bronchogenic cysts (BCs) are generally detected in the mediastinum, along the tracheobronchial tree, or in the lung parenchyma. Subcutaneous BCs are rare, but, when found, are usually small (

Objective: To review the surgical outcomes of primary mediastinal cysts (PMCs) and to determine the differences among various histopathological types. Methods: We retrospectively analysed the medical records of 41 patients (19 men, 22 women; mean age 46.5 ± 13.7 years, range 19-78 years) with PMCs who underwent surgical excision betweeen January 2007 and January 2016. Age, sex, indication for surgical intervention, surgical technique, histopathological diagnosis, postoperative complications and duration of hospital stay were recorded for all patients. The differences among the various histological types of PMCs were determined using analysis of variance for continuous variables and Chi-square test for categoric variables. A p-value of less than 0.05 was considered statistically significant. Results: A total of 41 patients with PMCs were managed surgically at our clinic over a period of 9 years. A total of 19 men (46.3%) and 22 women (53.7%) were included in the study. The patients had a mean age of 46.5 ± 13.7 years, a mean duration of hospital stay of 4.0 ± 1.0 days and a mean postoperative follow-up duration of 11.2 ± 3.7 months. According to the histopathological analysis, 21 (51.2%) patients were diagnosed as having a pericardial cyst; 16 (39%) had a bronchogenic cyst; 3 (7.3%) had a cystic hygroma and 1 (2.4%) had a thymic cyst. No postoperative mortality or recurrence was observed over a period of 11.2 ± 3.7 months. No statistically significant difference was found among the variables, either. Conclusion: Despite advanced non-invasive diagnostic techniques, the definitive diagnosis of PMCs can only be made by interventional techniques. Surgery often provides curative therapy with low morbidity and mortality. [ABSTRACT FROM AUTHOR]

Objectives: Bronchogenic cyst is a rare congenital disease which occurs especially in the neck region. This report presents 6 cases of bronchogenic cysts and discusses the diagnosis and surgical experience of this anomaly. Methods: A retrospective study of 6 pediatric patients with cervical bronchogenic cysts treated in our hospital during 2016 to 2019 was performed. We recorded and analyzed the clinical data of the patients, including age, symptoms, imaging findings, surgical procedure, and complications. Results: All patients underwent surgical excision. The chondroid tissues were found at the base of cysts which clung to the trachea in 5 patients and completely removed by surgery without recurrence. One patient showed recurrence due to residual cartilage after the first surgery, and the second surgery was required to resect the remaining cartilage. During the surgery, the recurrent laryngeal nerve (RLN) detector was used, which confirmed that all the RLNs clung to the side wall of cysts. All cases were cured without complications. Conclusions: Although rare, bronchogenic cysts should be considered in the differential diagnosis of peritracheal masses in children. Complete resection of the bronchogenic cysts, including the cartilages at the base, is vital in preventing recurrence. The RLN must be protected during the surgery. [ABSTRACT FROM AUTHOR]

Objective: We characterize computed tomography (CT) and magnetic resonance imaging (MRI) features of bronchogenic cysts (BCs) and analyze misdiagnosis. Methods: The retrospective study consisted of 83 patients with BCs. CT and MRI images were assessed for mass location, maximum diameter, density, calcification, signal intensity, and enhancement pattern. Eighty-three patients underwent plain CT in which 53 underwent enhanced CT. Thirteen patients received both plain and enhanced MR, and only one received just a plain MR. Results: Eighty-three masses were all solitary, with 71 having a roundish morphology, and twelve having a lobulated or irregular morphology. Sixty-six masses are mediastinal type, four are intrapulmonary type, and 13 are ectopic type. Calcification occurred in 14 lesions. On plain CT, 13 lesions displayed water-like attenuation (-20- 20 Hu), and 70 showed soft-tissue attenuation (=21 Hu). On T1WI, eight masses were hyperintense, three were isointense, and three were hypointense. Fourteen masses were hyperintense on T2WI and (Apparent Diffusion Coefficient) ADC sequence. On (Diffusion Weighted Imaging) DWI, six masses were hypointense and eight were hyperintense. Enhanced T1WI showed seven cases were unenhanced, while six were marginally enhanced. Twenty cases were misdiagnosed as thymomas, eleven as neurogenic tumors, six as lymphangiomas, and two as lung cancer. Five cases were misdiagnosed as other diseases. Patients with BCs underwent MR (42.9%) had a lower rate of misdiagnosis than those who underwent CT alone (53.0%). Conclusion: The imaging findings of BCs in the chest are generally consistent. Misdiagnosis occurs frequently when CT attenuation values exceed 20 Hu. Diagnostic accuracy of BCs tends to improve with preoperative MR examination. [ABSTRACT FROM AUTHOR]

Introduction: Bronchogenic cyst is a developmental anomaly of primitive foregut, usually diagnosed at birth or soon after. Commonly seen as intrapulmonary and mediastinal pathology, it is also reported at other sites, including neck, as a subcutaneous swelling. It seldom produces symptom unless it keeps growing due to persistent secretion and produces compressive symptoms. Abscess formation, discharging sinus or malignant transformation may occur rarely. Case report: A 26 years old male presented with a midline suprasternal swelling. Clinical examination revealed a 6x4cm size soft, mobile, nontender, cystic swelling which did not move upward on deglutition or on protrusion of tongue. Radiological evaluation of neck confirmed a cystic lesion in subcutaneous plane. Differential diagnosis of Thyroglossal cyst, dermoid cyst, branchial cyst, bronchogenic cyst, and Trichilemmal cyst were considered. Histological examination following excision confirmed the diagnosis of Bronchogenic cyst. Discussion: Surgery is the treatment of choice in cases of cervical cystic swellings which merit a wide range of differential diagnosis. Diagnosis of Bronchogenic cyst is confirmed by typical respiratory epithelial lining with interspersed goblet cells and smooth muscle fibres in the cyst lining.

Intrathymic bronchogenic cysts are extremely rare lesions, and the differential diagnosis with a banal thymic cyst or a solid tumor can be problematic. Thymic carcinomas arising within thymic cysts have also been reported. We report a case of radical thymectomy for a slowly growing small thymic cyst. The pathological finding revealed a bronchogenic cyst rather than a thymic neoplasm.

Bronchogenic cyst results from abnormal bronchial budding. Thin-stalked mobile bronchogenic cysts are rare and sometimes radiologically mimic mass lesion, making preoperative diagnosis difficult. We present a 12-year-old boy with a preoperative diagnosis of intraparenchymal cystic lung lesion misled by radiology. We performed a mini-thoracotomy revealing a thin stalked mobile elongated cyst that arose from the right inferior pulmonary ligament, confirmed as a bronchogenic cyst in histopathology.

Intramural esophageal bronchogenic cysts (EBCs) are rare congenital malformations. Differences in reports on the clinical features of intramural EBCs and some controversies about the treatment strategy for intramural EBCs exist. To investigate the clinical characteristics of intramural EBCs and evaluate the safety and efficacy of endoscopic resection. The clinical and endoscopic features, endoscopic resection treatment, postoperative adverse events, and follow-up results of 17 patients with intramural EBCs were retrospectively studied. Intramural EBCs exhibited male predominance with a male/female ratio of 58.8% (10/7) and were predominantly found in the distal esophagus. Approximately 94.1% of patients presented with gastrointestinal symptoms. All lesions were protruding masses covered by intact mucosal epithelium. The morphologies of intramural EBCs were diverse under white light endoscopy. On endoscopic ultrasonography, intramural EBCs presented as homogeneous or inhomogeneous hypoechoic or anechoic lesions. Eleven lesions originated from the muscularis propria, which underwent submucosal tunnel endoscopic resection (STER), and six lesions were from the submucosa, which underwent endoscopic submucosal dissection (ESD). Approximately 88.2% of patients underwent complete endoscopic resection. No serious pneumothorax, bleeding, pleural effusion, esophagotracheal fistula, or other adverse events occurred in all patients after endoscopic resection, and no cyst recurrence, metastasis, or esophageal scar stenosis was observed during the follow-up period. Intramural EBCs can be treated by digestive endoscopic surgery. STER and ESD are safe, effective, and minimally invasive resection methods. [ABSTRACT FROM AUTHOR]

Background: Bronchogenic cysts (BCs) refer to congenital lesions that result from primitive or abnormal foregut budding, and can be pulmonary or mediastinal. Their occurrence can take place at any point on the tracheobronchial tree, but they are usually localized in the lung parenchyma and mediastinum, and may be symptomatic or asymptomatic. Bronchogenic cyst symptoms can vary, depending on the size and location of the cyst. Methods: A retrospective review of the charts of five patients with a histopathological diagnosis of bronchogenic cysts was performed between 2014 and 2020. The patients reported in this study were diagnosed and managed at Abha Maternity and Children Hospital, Abha, southwest Saudi Arabia. In addition, demographic information, as well as diagnostic and therapeutic information, was provided for each patient, both at discharge and after discharge. All patients had confirmed congenital bronchogenic cysts with different clinical phenotypes and radiological findings. Results: All patients had histopathologically confirmed bronchogenic cysts with different clinical and radiological presentations. Two patients had mediastinal-located cysts; one had a laryngeal cyst; and the last two patients had infected intrapulmonary bronchogenic cysts. All patients underwent complete excision and did not experience recurrence or other postoperative complications during the follow-up period. The latter two patients required lobectomies of the right middle and upper lobes. Conclusions: Although bronchogenic cysts are considered a rare congenital pulmonary malformation, they should be considered in the differential diagnosis of pediatric patients with unusual airway and parenchymal lung manifestations, particularly, persistent stridor, feeding difficulty, and complicated pneumonia. Surgical excision of the cyst is the gold-standard therapy for symptomatic bronchogenic cysts and is highly recommended for asymptomatic ones. Long-term follow-up studies will be required to explore any long-term complications of BCs, particularly regarding the malignancy transformation. [ABSTRACT FROM AUTHOR]

Bronchogenic cysts are congenital malformations caused by aberrant foregut budding. They major occur in the thorax, with subdiaphragmatic cases being uncommon. Here, we present a series of 19 patients diagnosed with subdiaphragmatic bronchogenic cysts histopathologically at a single institution in China from 2012 to 2021. A literature review was also conducted by searching the PubMed database using keywords related to “bronchogenic cysts” and “subdiaphragmatic,” yielding 107 cases. Taken together, the 126 cases had a median age of 41.0 years (interquartile range, 30.0–51.0 years) and 62 of them were male (49.2%). The cysts were most commonly detected in the left adrenal region (36.2%), followed by the pancreatic region (11.5%) and gastric cardia/lesser curvature of the stomach (9.2%). All patients except two underwent surgery for a definite diagnosis, symptom alleviation, and (or) malignancy prevention. Most patients recovered fast and were discharged from the hospital within 1 week after surgery, and the surgical complications were infrequent. The prognosis was generally favorable, as no recurrence was reported during the follow-up as long as 77 months.