Visual diagnosis in emergency medicine| Volume 39, ISSUE 5, P650-651, November 2010

Bronchogenic Cyst

      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 thumbnail gr1
      Figure 1Chest radiograph. The white arrow points to a bilocular, subcarinal lesion with air-fluid level.
      Figure thumbnail gr2
      Figure 2Computed tomographic scan of the chest with contrast. The black arrow points to a well-defined, spherical, cystic lesion in mediastinum.
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