[Neck bronchogenic cyst. Case report and review of the literature]. / Quiste broncogénico en cuello. Reporte de un caso y revisión de la bibliografía.

BACKGROUND: Bronchogenic cyst is a malformation of the ventral portion of the intestine, which is limited by bronchial epithelium and produces alterations in the development of the tracheobronchial tree. They may be single or multiple, and are usually confined to one lung or to the mediastinum, rarely to the neck, which is a subcutaneous tissue. OBJECTIVE: The case of a 9 year old girl is reported, who presented with a clinical picture characterized by a slow-growing, asymptomatic tumour on the left side of the neck of 4 years onset. Chest X-ray, neck ultrasound and computed tomography of the neck and chest ruled out any other injury. A complete resection was performed, and the histopathological study confirmed the diagnosis of bronchogenic cyst. CONCLUSION: The symptomatology of a bronchogenic cyst is due to the compression of the vascular, digestive or air structures, as well as its size, infection and location. The treatment of choice is a surgical resection, even when asymptomatic.

Voluminous oesophageal bronchogenic cyst treated with thoracoscopic approach.

AIM: Bronchogenic cysts are congenital lesions deriving from the primitive foregut, and are usually located in close relation to tracheobronchial tree or oesophagus. We report a case of an oesophageal bronchogenic cyst appearing at preoperative examinations as a benign fibromuscular tumour (leiomyoma). CASE REPORT: A 62 years old male patient in good general conditions, was admitted to our Institution because of moderate dysphagia and upper post-prandial abdominal pain. Conventional imaging, endoscopy and echo endoscopy detected a parietal oesophageal wall mass looking like a solid formation, determining extrinsic compression and narrowing of the lumen. RESULTS: The mass has been radically removed with thoracoscopic approach. Postoperative stay was uneventful and the patient was discharged three days after the operation. At histological examination the mass appeared as a cystic formation with fibromuscular wall and ciliated epithelium (so-called disembriogenetic bronchogenic cyst). CONCLUSION: The case we have reported describes a very unusual case of a voluminous symptomatic intramural oesophageal disembriogenetic cyst whose characteristics had not been defined at preoperative examinations. Surgical removal of the mass has been achieved with a minimally invasive approach.

Supradiaphragmatic bronchogenic cyst extending into the retroperitoneum.

We experienced a case of bronchogenic cyst located on the left lower pleural space extending into the retroperitoneum in a 33-year-old man with left chest pain. Preoperative imaging studies and operative findings showed a broad-based cystic mass on the left lower posterior pleura and diaphragmatic pleura extending into the retroperitoneal region across the diaphragm. Histologic studies proved this mass to be a bronchogenic cyst.

Outcome predictors for infants with cystic lung disease.

BACKGROUND/PURPOSE: This study aimed at identifying characteristic features indicating congenital cystic adenomatoid malformation of the lung (CCAM) and evaluating the outcome predictors to identify prenatally subgroups of fetuses with significantly different probabilities of mortality or severe respiratory difficulty. METHODS: Twenty-eight neonates who had undergone antenatal evaluation for cystic lung disease (CLD) were reviewed retrospectively. The patients were divided into 3 groups according to the severity of their clinical course; mild (n = 7), moderate (n = 13), and severe (n = 8). Ultrasonographic findings in the fetus and their pulmonary lesion were evaluated. The normal lung to thorax transverse area ratio (L/T) was measured by ultrasonography. RESULTS: High echogenicity of the lesion throughout pregnancy and polyhydramnios were frequently seen in CCAM. All of the patients with other CLD showed isoechogenicity at the end of pregnancy. All patients in the severe group had both polyhydramnios and fetal hydrops. L/T was increased in mild and moderate groups, whereas no patient in the severe group had an increase in L/T at the final measurement. Each value of final L/T in the severe group was less than 0.25. CONCLUSIONS: The subgroup of fetuses with an increased probability of mortality or severe respiratory difficulty could be predicted from the combination of polyhydramnios, fetal hydrops, and a final L/T value of less than 0.25.

[Air-filled cysts of tracheal origin: nosological problems and actual frequency]. / Kystes aériens d'origine trachéale: problèmes nosologiques et fréquence réelle.

Air-filled paratracheal bronchogenic cysts are extremely rare. They are lined by respiratory epithelium. We have operated on 2 patients whose cysts were diagnosed by CT scan: one presenting with bloody sputum and the other with dysphagia. Both patients had a history of neck surgery. Because such cases are rare in the literature, their exact origin, whether tracheocele, diverticulum or other form of air-filled cyst, remains a matter of debate. However, their frequency is probably underestimated because most cause few symptoms and are well tolerated. In a recent radiologic study their prevalence was found to be 2% in patients undergoing CT scan.

Prenatal diagnosis of a bronchogenic cyst in an unusual site.

We report a rare case of a subdiaphragmatic cyst, diagnosed prenatally during routine ultrasound screening at 25 weeks' gestation. Serial ultrasonographic evaluation demonstrated a slight increase in the size of the cyst during pregnancy. On the basis of the anatomic site and the sonographic features of the lesion, four diagnostic hypotheses were postulated: cystic neuroblastoma, adrenal hemorrhage, duplication of the inferior third of the esophagus and retroperitoneal cystic lymphangioma. A healthy baby, weighing 3300 g and with Apgar scores of 8 and 9, was delivered vaginally at term. He underwent successful surgery at the age of 3 months. The post-operative course was uneventful and the baby is currently doing well. Histology revealed a bronchogenic cyst.

[Mediastinal esophago-bronchogenic cyst presenting as a single mass].

An abnormal shadow was found on a chest X-ray film of a 42-year-old man. The mass was 17 x 12 x 11 cm, smooth, round, homogeneous, and was seen in the left upper lung field. Chest computed tomography revealed a cystic mass in contact with the left lung, the chest wall, the esophagus, and the aorta. Magnetic resonance imaging showed a wall that divided the mass into two compartments. The cystic lesion was removed and was found to contain a yellow liquid. The larger part of the mass was histologically similar to esophageal wall and the smaller part was bronchogenic. The final diagnosis was mediastinal esophago-bronchogenic cyst. In previously reported cases, two cystic masses were connected by a canal. The findings in this case support the theory by Yoshii that this type of cyst originates from the diverticulum of the foregut near the lung bud.

[A variety of mediastinal bronchogenic cyst: the broncho-alveolar cyst]. / Varietà di cisti broncogena del mediastino: cisti bronco-alveolare.

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.

[Retroperitoneal adrenal subdiaphragmatic bronchogenic cyst: apropos of a case and review of the literature]. / Le kyste bronchogénique sous-diaphragmatique sus-rénal rétro-péritonéal: à propos d'un cas et revue de la littérature.

The authors report a case of retroperitoneal subdiaphragmatic bronchogenic cyst. The embryological and histological features of the cyst are discussed, together with the diagnostic and therapeutic modalities.

Congenital malformations of the lung.

Congenital malformations of the lung are a frequent cause of abnormal chest radiographs in neonates and young children as well as a common cause for recurrent pneumonia in older patients. Based on the mode of presentation and clinical findings along with an understanding of lung embryology, one can develop a thorough differential diagnosis that allows for the evaluation of the lesion in question. Appropriate management of the patient can then be undertaken with a minimum of diagnostic studies and without any delay in treatment.

An unusual lateral neck cyst with the combined features of a bronchogenic, thyroglossal, and branchial cleft origin.

Soft tissue cystic masses arising in the neck in children are commonly of embryologic origin and often surgically excised. Depending on location and histology, they can be classified as thyroglossal duct, branchial cleft, or rarely bronchogenic in origin. We present an unusual case of an infant with a lateral neck mass that communicates with the midtrachea. The histologic appearance is that of a combination of the features seen in cysts of branchial cleft and thyroglossal duct origin. The possible embryologic development of such a lesion is discussed.

Coexistence of bronchial atresia and bronchogenic cyst: diagnostic criteria and embryologic considerations.

We report a case in a neonate of concurrent bronchial atresia and bronchogenic cyst. An accurate, noninvasive, preoperative diagnosis of this unusual combination of anomalies was made by ultrafast computed tomography (UFCT). This case supports the hypothesis that bronchial atresia results from an event occurring in the 5th-6th week of embryological development, rather than after the 16th week as previously believed.

Quiste broncogénico de piel : a propósito de un caso / Bronchogenic skin cyst : apropos of a case

Se presenta un caso de quiste broncogénico localizado en la piel preesternal, se describe su embriopatogenia, una breve reseña de su casuística hasta la fecha, los posibles diagnósticos diferenciales y su tratamiento.

Quiste broncogénico de piel : a propósito de un caso / Bronchogenic skin cyst : apropos of a case

Se presenta un caso de quiste broncogénico localizado en la piel preesternal, se describe su embriopatogenia, una breve reseña de su casuística hasta la fecha, los posibles diagnósticos diferenciales y su tratamiento. (AU)

[Intramural bronchogenic esophageal cyst: an uncommon event in esophageal surgery]. / De intramurale bronchogene slokdarmcyste: een curiosum in de slokdarmchirurgie.

Intramural bronchogenic cysts of the esophagus are uncommon. These benign esophageal tumors result from a wrong cleavage of the primitive gut in the 4 weeks old embryo. Symptoms are often absent or atypical. By roentgenography and esophagoscopy, the diagnosis of benign tumor can be made. Even CT-scan can't give absolute certainty about the exact nature of the lesion. An exploratory thoracotomy, with enucleation of the tumor, is needed in all cases for definite diagnosis and treatment. The cysts are lined by columnar ciliated epithelium of the respiratory type. The presence of hyaline cartilage within the wall of the cyst allows to make the difference for sure between an esophageal cyst of bronchogenic origin and a cyst of enterogenous origin.