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Department of Emergency Medicine, Chi-Mei Medical Center, Yung-Kang City, TaiwanGraduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan
Department of Emergent Medicine, Chi-Mei Hospital, Liouying, Tainan, TaiwanDepartment of Environmental and Occupational Health and Department of Occupational and Environmental Medicine, Medical College, National Cheng Kung University, Tainan, Taiwan
A 60-year-old man presented to the Emergency Department (ED) complaining of cough
of 3 months duration. He had been prescribed antitussives in clinics for presumed
bronchitis. However, the cough did not respond to treatment and was followed by one
episode of hemoptysis the night before his ED presentation. The patient did not smoke
and denied fever, body weight loss, or dyspnea. A chest radiograph was taken and a
soft-tissue lesion with an air-fluid level was seen in the mediastinum (Figure 1). A computed tomography (CT) scan of the chest demonstrated a bilocular cystic lesion
beneath the carina (Figure 2). Thoracotomy showed a 5 × 5-cm cystic lesion with jelly-like content in the mediastinum.
Examination of the pathologic specimen revealed ciliated columnar epithelium and bronchial
mucous glands consistent with a bronchogenic cyst. The patient had an uneventful postoperative
course.
Figure 1Chest radiograph. The white arrow points to a bilocular, subcarinal lesion with air-fluid
level.
