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1.
BMJ Case Rep ; 17(3)2024 Mar 04.
Article in English | MEDLINE | ID: mdl-38442975

ABSTRACT

Bronchogenic cysts are rare congenital lesions found primarily in the mediastinum. Most patients are asymptomatic and can be treated with minimally invasive resection. We present a case of a middle-aged patient who presented to a district general hospital with palpitations and shortness of breath. She underwent a computerised tomographic pulmonary angiogram that showed a likely bronchogenic cyst and was subsequently transferred to our hospital. She developed atrial fibrillation during admission requiring therapy with beta-blockers and digoxin. Cardiac MRI revealed a large cyst posterior to the left atrium, a moderate circumferential pericardial effusion and bilateral pleural effusions. There was significant left atrial compression. The patient underwent surgical removal of the cyst and was discharged. She returned to the hospital within a week with palpitations and was treated with intravenous antibiotics for sepsis. She was discharged a week later and remained clinically stable.


Subject(s)
Atrial Fibrillation , Bronchogenic Cyst , Middle Aged , Female , Humans , Atrial Fibrillation/etiology , Bronchogenic Cyst/complications , Bronchogenic Cyst/diagnostic imaging , Bronchogenic Cyst/surgery , Heart Atria , Digoxin , Mediastinum
2.
Kyobu Geka ; 76(9): 741-744, 2023 Sep.
Article in Japanese | MEDLINE | ID: mdl-37735737

ABSTRACT

A 26-year-old man referred to our hospital because of dysphagia and a mediastinal tumor detected on chest computed tomography (CT). A contrast-enhanced CT revealed a 12 cm long cystic tumor along the right thoracic esophagus. An upper gastrointestinal endoscopy showed no abnormalities in the esophageal mucosa, and an unclear boundary between the tumor and the esophageal wall was observed by echography. In surgery, the tumor and the esophagus were in one lump, and esophagectomy was performed. On the fourth postoperative day, esophagogastric anastomosis was performed with poststernal reconstruction, and the patient was discharged home on the 38th postoperative day. Pathological examination revealed that the mass was a cystic lesion within the esophageal muscular layer, and the cyst wall was coated with airway-like multi-lineal hairy epithelium, which led to the diagnosis of a bronchogenic cyst. Even if the cyst is within the esophageal muscularis layer, bronchogenic cyst should be considered in the differential.


Subject(s)
Bronchogenic Cyst , Deglutition Disorders , Male , Humans , Adult , Deglutition Disorders/etiology , Deglutition Disorders/surgery , Esophagectomy , Bronchogenic Cyst/complications , Bronchogenic Cyst/diagnostic imaging , Bronchogenic Cyst/surgery , Muscles
3.
Medicine (Baltimore) ; 102(18): e33613, 2023 May 05.
Article in English | MEDLINE | ID: mdl-37144997

ABSTRACT

RATIONALE: Lymphocytic interstitial pneumonia (LIP) is a rare benign lymphoproliferative disorder, often associated with autoimmune diseases. Most LIPs present with multiple bronchial cysts and diffuse interstitial infiltration. It is histologically characterized by widespread diffuse lymphocytic infiltration of the pulmonary interstitium, and the enlargement and widening of the alveolar septum. PATIENT CONCERNS: A 49-year-old woman was admitted to hospital for finding pulmonary nodules for more than 2 months. 3D imaging chest computed tomography (CT) examination of both lungs showed that there was a middle lobe of the right lung with a size of about 1.5 cm × 1.1 cm ground-glass nodules. DIAGNOSES: A single operating port thoracoscopic wedge resection biopsy of a right middle lung nodule was performed. The pathology showed diffuse lymphocytic infiltration with varying numbers of small lymphocytes, plasma cells, macrophages and histiocytes infiltrating the alveolar septa, widened and enlarged alveolar septa, and scattered lymphoid follicles. Immunohistochemically, CD20 positive in follicular area, CD3 positive in interfollicular area. LIP was considered. INTERVENTIONS: The patient was regularly followed without any specific treatment. OUTCOMES: Follow-up chest CT showed no significant abnormalities in the lungs 6 months after surgery. LESSONS: To the best of our knowledge, our case may be the second reported case of a patient with LIP presenting with a ground glass nodule on chest CT, and it is speculated that the ground glass nodule may be an early manifestation of idiopathic LIP.


Subject(s)
Bronchogenic Cyst , Lung Diseases, Interstitial , Female , Humans , Middle Aged , Lung Diseases, Interstitial/etiology , Lung/diagnostic imaging , Lung/pathology , Plasma Cells/pathology , Bronchogenic Cyst/complications
4.
BMJ Case Rep ; 16(1)2023 Jan 13.
Article in English | MEDLINE | ID: mdl-36639197

ABSTRACT

Bronchogenic cysts (BCs) are congenital foregut malformations and usually asymptomatic, thin-walled, incidentally diagnosed cysts which can be easily resected by a minimal invasive approach at this time point. However, they may develop symptoms such as infection, bleeding or compression of adjacent structures. There is no consensus about the risk of developing complications during a lifetime; however, recent reports suggest a higher incidence than initially believed. Here, we report a case of severe life-threatening mediastinitis emerging from an infected BC requiring complex surgery, which could have been avoided if surgery had been performed at an early, asymptomatic stage.


Subject(s)
Bronchogenic Cyst , Mediastinitis , Humans , Bronchogenic Cyst/complications , Bronchogenic Cyst/diagnostic imaging , Bronchogenic Cyst/surgery , Mediastinitis/diagnosis , Mediastinitis/etiology , Diagnosis, Differential
8.
Am J Case Rep ; 23: e935247, 2022 Jan 03.
Article in English | MEDLINE | ID: mdl-34979531

ABSTRACT

BACKGROUND Bronchogenic cysts are foregut duplication cysts that result in congenital cysts of the tracheobronchial tree. They can be fatal especially, if they present in early infancy. Persistent respiratory distress is the most frequent reported presentation. Histologically, bronchogenic cysts are unilocular fluid-filled lesions that are composed of respiratory epithelium. This report presents the case of a 4-month-old girl with persistent respiratory distress and multiple admissions to the Pediatric Intensive Care Unit (PICU) due to a congenital bronchogenic cyst. CASE REPORT We describe a 4-month-old girl with persistent respiratory distress, intermittent chocking, and recurrent PICU admissions. The patient was managed as a case of bronchiolitis, which led to ineffective treatment numerous times. Radiological work-up revealed unusual findings of asymmetrical hyperinflation. Bronchoscopy, which was performed to clear the airway and retrieve a possible foreign body, showed a non-pulsatile mass compressing the entry of the main bronchi with more pressure on the left main bronchus, raising the possibility of an external compression. A bronchogenic cyst was suspected and confirmed with high-resolution computed tomography (HRCT). Surgical intervention was performed, with no reported complications. CONCLUSIONS This report has shown that in neonates presenting with respiratory distress and no signs of infection, a broad differential diagnosis including congenital cysts should be considered. As in this case, lung and thoracic imaging are required to confirm the diagnosis. We also highlight the need to involve subspecialities to avoid potential delay in diagnosis or exposing patients to unexpected complications.


Subject(s)
Bronchogenic Cyst , Respiratory Distress Syndrome , Bronchogenic Cyst/complications , Bronchogenic Cyst/diagnosis , Bronchogenic Cyst/surgery , Child , Dyspnea , Female , Humans , Infant , Infant, Newborn , Intensive Care Units, Pediatric , Neoplasm Recurrence, Local
9.
Ann Thorac Surg ; 113(1): e45-e47, 2022 Jan.
Article in English | MEDLINE | ID: mdl-33757740

ABSTRACT

Emergency medical assistance is rare regarding air travel. Pulmonary barotrauma during air travel can occur in asymptomatic patients who have underlying intraparenchymal pulmonary pathology such as bullae or bronchogenic cysts. During aircraft travel the resultant decrease in pressure during the ascent can lead to expansion of cyst volume, culminating in tears and leakage of air into the surrounding vasculature and thus the potential for air embolism. We describe a case of massive cerebral air embolism secondary to pulmonary barotrauma in a previously asymptomatic patient.


Subject(s)
Barotrauma/complications , Bronchogenic Cyst/complications , Embolism, Air/complications , Stroke/etiology , Adult , Bronchogenic Cyst/etiology , Embolism, Air/etiology , Female , Humans
10.
J Pak Med Assoc ; 72(11): 2298-2301, 2022 Nov.
Article in English | MEDLINE | ID: mdl-37013307

ABSTRACT

Mediastinal Neuroenteric Cyst is a rare congenital presentation in infants and is associated with a high mortality rate. It is a very uncommon benign lesion and usually develops from abnormal embryological development of the foregut. Till now, only 106 cases have been reported worldwide. In Pakistan only three cases have been published, with varying presentations. The clinical presentation and age at presentation vary from asymptomatic and coincidental finding on chest x-ray, to limb numbness or early presentation with severe symptoms like those in our case. In fact, it poses an important challenge for paediatricians. We present a rare case with emphasis on clinical presentation and diagnostic criteria.


Subject(s)
Bronchogenic Cyst , Mediastinal Cyst , Neural Tube Defects , Respiratory Distress Syndrome , Respiratory System Abnormalities , Infant , Humans , Bronchogenic Cyst/complications , Bronchogenic Cyst/diagnosis , Mediastinal Cyst/complications , Mediastinal Cyst/diagnostic imaging , Mediastinal Cyst/surgery , Neural Tube Defects/diagnosis , Neural Tube Defects/diagnostic imaging
14.
J Cardiothorac Surg ; 16(1): 29, 2021 Mar 19.
Article in English | MEDLINE | ID: mdl-33740997

ABSTRACT

BACKGROUND: Large intracardiac bronchogenic cysts are rare mediastinal masses. However, they must always be considered in the differential diagnosis of heart failure with abnormal chest X-ray. CASE PRESENTATION: We present a 60-year-old female patient with de novo atrial fibrillation, heart failure and a very large intrapericardial mass. The patient underwent successful surgical resection, with pathological findings confirming a bronchogenic cyst. CONCLUSIONS: Large bronchogenic cysts located intrapericardially are very rare. However, they should be included in the differential diagnosis of patients presenting with atrial fibrillation and heart failure with abnormal radiologic studies.


Subject(s)
Atrial Fibrillation/etiology , Bronchogenic Cyst/diagnosis , Heart Failure/complications , Pericardium/diagnostic imaging , Aged , Atrial Fibrillation/complications , Atrial Fibrillation/diagnosis , Bronchogenic Cyst/complications , Bronchogenic Cyst/surgery , Diagnosis, Differential , Female , Heart Failure/diagnosis , Humans , Magnetic Resonance Imaging , Radiography, Thoracic , Tomography, X-Ray Computed
18.
Indian J Cancer ; 57(2): 205-208, 2020.
Article in English | MEDLINE | ID: mdl-32445326

ABSTRACT

Intra-abdominal bronchogenic cysts are rare entities and only a handful of cases occurring within the lesser sac have been described. Further, the development of malignancy in a bronchogenic cyst is exceptional and one arising in a lesser sac has so far not been reported. We present herein an account of a 44-year-old man who presented with recurrent upper abdominal pain. Investigations revealed a mass in the lesser sac and a hydatid cyst in the liver. The histopathological examination of the excised mass showed bronchogenic cyst, with a neuroendocrine tumor of intermediate grade arising in its wall. Concomitant presence of hydatid cyst in the liver made this case even more unusual.


Subject(s)
Bronchogenic Cyst/complications , Echinococcosis/pathology , Neuroendocrine Tumors/complications , Adult , Humans , Male
19.
World Neurosurg ; 139: 182-185, 2020 07.
Article in English | MEDLINE | ID: mdl-32305607

ABSTRACT

BACKGROUND: Intracranial bronchogenic cysts (BCs) are extremely rare. To our knowledge, this is the first report of a BC in which lesions involve the middle and posterior cranial fossa, as well as the infratemporal fossa. CASE DESCRIPTION: We present the case of a 38-year-old woman who suffered from a cranial nerve dysfunction for 2 years. Magnetic resonance imaging showed that there were skull base communication lesions across the middle and posterior fossa. The patient was operated on through an infratemporal fossa approach. The final diagnosis was BC after histopathologic examination and immunohistochemical verification. The patient's neurologic dysfunction was partially ameliorated at the half-year follow-up. CONCLUSIONS: Intracranial BCs are rare. However, they should be considered in the differential diagnosis for cystic lesions with edge enhancement or extracranial extension.


Subject(s)
Bronchogenic Cyst/surgery , Skull Base/surgery , Adult , Bronchogenic Cyst/complications , Bronchogenic Cyst/diagnostic imaging , Bronchogenic Cyst/pathology , Cranial Fossa, Middle , Cranial Fossa, Posterior , Craniotomy , Facial Paralysis/etiology , Female , Hearing Loss/etiology , Humans , Hypesthesia/etiology , Magnetic Resonance Imaging , Neurosurgical Procedures , Skull Base/diagnostic imaging , Skull Base/pathology , Tomography, X-Ray Computed
20.
Medicine (Baltimore) ; 99(9): e19347, 2020 Feb.
Article in English | MEDLINE | ID: mdl-32118772

ABSTRACT

INTRODUCTION: Pulmonary sequestration (PS) is a rare congenital malformation defined as nonfunctioning lung tissue supplied by systemic circulation. It is uncommonly diagnosed in adults. Herein, we describe a clinical case of PS with cystic degeneration mimicking a bronchogenic cyst in an elderly patient. PATIENT CONCERNS: A huge cystic mass was incidentally found in a 65-year-old man on chest computed tomography (CT) scans during preoperative workup for a hand laceration. A 15-cm-sized round cystic mass was detected in the right lower lobe. DIAGNOSIS: After reviewing the chest CT scan, we decided to perform contrast-enhanced chest magnetic resonance imaging (MRI) and CT-guided lung aspiration biopsy. On MRI, the lesion had the appearance of a cystic mass with hemorrhagic clots, such as an intrapulmonary bronchogenic cyst. The aspirated specimen was nondiagnostic; thus, we decided to surgically remove the mass. INTERVENTIONS: Upon right lower lobectomy, the mass was diagnosed as a PS. A thin systemic artery supplying the cystic mass was visualized during surgery. OUTCOMES: The patient is undergoing regular follow-up at the outpatient clinic. CONCLUSIONS: PS should be considered as a differential diagnosis in patients with a cystic lung mass. Identification of a systemic artery on radiologic imaging is important in the diagnosis of PS before preoperative workup to prevent unpredicted massive bleeding during surgery.


Subject(s)
Bronchogenic Cyst/complications , Bronchopulmonary Sequestration/etiology , Aged , Bronchogenic Cyst/physiopathology , Bronchopulmonary Sequestration/physiopathology , Diagnosis, Differential , Geriatrics/methods , Humans , Male , Paracentesis/methods , Tomography, X-Ray Computed/methods
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