[A case of bronchogenic cyst with elevated SLX levels in serum and cystic fluid].

A 27-year-old man was admitted with chest pain and cough in January 1999. Chest radiograph on admission showed a widened tracheal bifurcation. Computer tomography on admission showed a low density mass located at the tracheal bifurcation. Magnetic resonance imaging of the chest showed a well defined mass with isointensity on T1-weighted images, and high intensity on T2-weighted images. Laboratory data on admission showed mild inflammatory findings and a high level of Sialyl Lewis X-i antigen (SLX) in serum. Thoracotomy revealed a cystic mass and pathologically, the cyst wall was lined with bronchial epithelium which showed no malignancy. The level of SLX in the cystic fluid was elevated, and immunohistochemical staining of the cystic epithelium was positive for SLX. After resection of the cyst, the level of SLX in serum decreased. This represents a rare case of bronchogenic cyst with a high level of SLX in serum and cystic fluid.

Bronchogenic cyst with high carbohydrate antigen 19-9 in the cyst fluid and the serum.

A mass of 8 cm in diameter was revealed in the right upper lung field of a 46-year-old female patient. The chest X-ray film taken one year previously revealed only a linear shadow in the same position, which was thought to be a vacant cyst. The levels of carbohydrate antigen (CA) 19-9 in cyst fluid and serum were elevated, at 410,000 and 130 U/ml, respectively. After surgical resection, serum CA19-9 returned to normal. Pathologically, the cyst wall was lined with bronchial epithelium with no evidence of malignancy. Immunohistochemical study revealed CA19-9 positivity in the bronchial epithelium of the cyst wall.

Subcarinal bronchogenic cyst with high carbohydrate antigen 19-9 production.

In a rare case of bronchogenic cyst with high carbohydrate antigen (CA) 19-9 production, a 57-year-old man with coughing and chest pain was diagnosed with a subcarinal mediastinal tumor. Fiberoptic bronchoscopy showed an erosive mucosal lesion overlying the area of extrinsic compression at the membranous of the right mainstem bronchus. Serum carbohydrate antigen 19-9 was elevated at 1300 U/ml. Thoracotomy showed an encapsulated cyst tightly adhering to the right main bronchus. The cyst was extirpated after ablation at the adherent cystic wall by electrocautery. Although intracystic carbohydrate antigen 19-9 concentration was very high, serum carbohydrate antigen 19-9 and bronchoscopic findings returned to normal postoperatively. The histological diagnosis was consistent with a bronchogenic cyst and carbohydrate antigen 19-9 could be immunohistochemically demonstrated within its epithelium.

[Mediastinal bronchogenic cyst associated with high serum level of CA19-9--a surgical case report].

We reported a case of mediastinal bronchogenic cyst in a patient with a high serum level of CA19-9. The patient, a 41-year-old man, presented with a complaint of persistent fever. Chest X-ray examination, computed tomography and magnetic resonance imaging showed a subcarinal mass shadow which was diagnosed preoperatively as a bronchogenic cyst. The serum level of CA19-9 was 73 U/ml. The cyst was partially removed via right thoracotomy. Histopathological findings were compatible with bronchogenic cyst. The CA19-9 level in the specimen was 134,00 U/ml. The serum level of CA19-9 decreased to normal postoperatively. The postoperative course was uneventful.

[A case of bronchogenic cyst in the posterior mediastinum with high level of serum SCC antigen].

A 78-year-old man was picked up by chest X-ray findings. His CT scan film showed a posterior mediasinal tumor shadow. Serum level of SCC antigen was high and thoracotomy revealed bronchogenic cyst with high production of SCC antigen. After resection of the cyst, his serum level of SCC was within normal range. It is proposed that the elevated serum level of SCC is due to chronic inflammation or structural feature of the cystic wall.

[A case of mediastinal esophago-bronchogenic cyst associated with high serum level of CA 19-9].

We report a case of mediastinal esophago-bronchogenic cyst in a patient with a high serum level of CA 19-9. A 49-year-old man presented with a complaint of dysphagia. Chest X-ray, CT, and MRI showed posterior mediastinal cystic shadow which was diagnosed preoperatively. The serum level of CA 19-9 was 158 U/ml. We underwent extirpation of the cyst through video-assisted thoracoscopic surgery (VATS) and confirmed to be a bronchogenic cyst histologically. The serum level of CA 19-9 returned to normal after the operation.

Mycobacterium avium lung disease combined with a bronchogenic cyst in an immunocompetent young adult.

We report a very rare case of a bronchogenic cyst combined with nontuberculous mycobacterial pulmonary disease in an immunocompetent patient. A 21-year-old male was referred to our institution because of a cough, fever, and worsening of abnormalities on his chest radiograph, despite anti-tuberculosis treatment. Computed tomography of the chest showed a large multi-cystic mass over the right-upper lobe. Pathological examination of the excised lobe showed a bronchogenic cyst combined with a destructive cavitary lesion with granulomatous inflammation. Microbiological culture of sputum and lung tissue yielded Mycobacterium avium. The patient was administered anti-mycobacterial treatment that included clarithromycin.

Fibrosing mediastinitis as a rare sequel of iatrogenic rupture of bronchogenic cyst--a case report.

Fibrosing mediastinitis is a chronic disease process with a spectrum of etiology. We report a 51-year-old female who underwent incision and drainage procedure in the neck for deep neck and mediastinal abscess. Five years later she developed fibrosing mediastinitis. This lesion infiltrated from neck base into the upper mediastinum with tracheal compression and vessel encasement. She had resection of the lesion which proved to be a ruptured bronchogenic cyst with chronic inflammation. This rare case illustrates the importance of including inflammatory bronchogenic cyst in the etiology of deep neck abscess formation. And we further find a ruptured bronchogenic cyst with chronic inflammation as an etiology of fibrosing mediastinitis.

Epithelioid sarcoma presenting as pulmonary cysts with cancer antigen 125 expression.

A 39-year-old Japanese woman presented with a swollen right hand and a right-sided pneumothorax. Chest CT revealed bilateral multiple pulmonary thin-walled cysts measuring

[Bronchial cyst in a patient with a high serum CA19-9 concentration that fluctuated with the cyst fluid volume].

A 44-year-old woman was found to have an abnormally high concentration of CA19-9 in serum. Five years later, she underwent a right upper lobectomy for an abnormal shadow on a chest roentgenogram, because it was thought to indicate a malignant tumor. A chest CT scan revealed a cyst with fluid in the right upper lobe. During the 5 years before the lobectomy, the serum CA19-9 concentration rose when the cyst fluid volume increased, and fell when the cyst fluid volume decreased. Before the operation, the serum CA19-9 concentration was very high and the cyst was swollen. The cyst wall was found to be lined with ciliated columnar epithelial cells and to contain hyaline cartilage and smooth muscle, which led to the diagnosis of bronchial cyst. The surface epithelium and cyst fluid were positively stained by a monoclonal antibody against CA19-9. The serum CA19-9 concentration decreased and was within the normal range 3 months after the operation.

[A resected case of bronchogenic cyst of the left hemidiaphragm with elevated serum CA19-9].

A rare case of bronchogenic cyst of the left hemidiaphragm is reported. A 53-year-old woman referred to our institution for an abnormal shadow on chest roentgenogram. Chest X-ray showed a 6 x 6 cm mass in the left lower lung filed. The margin of the mass was clear and the surface was smooth. The lateral view showed a mass on the diaphragm with the extrapleural sign. Chest CT demonstrated the mass as a multi loculated cyst. Celiac angiography demonstrated the branch of the inferior diaphragmatic artery at the margin of the mass. Her serum CA19-9 level was 470 U/ml. The patient underwent surgical exploration. Operative findings showed the smooth surface mass was on the diaphragm covered with pleura. Resected tumor was large as 7.5 x 6.5 x 4.0 cm. The surface was smooth and white-yellowish, and the cut surface presented a multi loculated cyts. Histopathological examination showed a bronchogenic cyst. CA19-9 in the cyst fluid was elevated as 445,900 U/ml. The serum CA19-9 level returned to normal after the operation.