Source: Annual Congress 2008 - Mediastinal lesions; rare pathology
Disease area: Respiratory infections, Thoracic oncology

Abstract

Background: Bronchogenic cysts (BC) represent the common lesion of the mediastinum. In small children these cysts can be life threatening when they compress vital structures. BC are the result of anomalous development of the ventral foregut; they are usually single but may be multiple.
Case report:O.D., female, 14 month old was admitted in our hospital with a atelectasia of the left lung.
The X-Ray : the atelectasia of the left lung
Chest CT : tumor mass 40 × 30 mm in size with a clear boundary in the left anterior mediastinum. The calcification in part of the wall. The left lung was total atelectasis.
The pulmonary scintigraphy : 5% pulmonary perfusion of the left lung .
Bronchoscopy : compression of the left brochus.
By lateral thoracotomy we discover into the left thoracic cavity a giant cyst arising from the trachea . The left bronchus and the left pulmonary artery was compresed by the cyst. The left lung was atelectasis.
We perform resection of the cyst. After resection left lung become at the normal status. A cyst contained yellowish-white mucus.
Histologically examination: bronchogenic cyst
Conclusion:BC has congenital origin derived from the primitive foregut and are the most common primary cysts of the mediastinum. Frequently unilocular, they contain clear fluid. They are lined by columnar ciliated epithelium, and their walls often contain cartilage and bronchial mucous glands.
Most of the complications result from compression of adjacent structures.
The differential diagnosis includes hydatidosis, fungal disease, tuberculosis, infected bullas, vascular malformations, and neoplasms.Complete extirpation, with ligation of attachment to the patent bronchus, is usually possible. The prognosis after excision is excelent.

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Citations should be made in the following way:
D. M. Nicolau (Cluj Napoca, Romania). Total left lung atelectasia by giant bronhogenic cyst. Eur Respir J 2008; 32: Suppl. 52, 2145

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