Bronchogenic cyst differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Joanna Ekabua, M.D. [2]

Overview

Bronchogenic cyst must be differentiated from lung abcess, thymic cyst, and esophageal duplication cysts

Differentiating Bronchogenic cyst from other Diseases

Differentiating bronchogenic cyst from lung abcess, thymic cyst, and esophageal duplication cysts

Diseases	Clinical manifestations						Para-clinical findings							Gold standard
	Symptoms			Physical examination
							Lab Findings			Imaging			Histopathology
	Symptom 1	Symptom 2	Symptom 3	Physical exam 1	Physical exam 2	Physical exam 3	Lab 1	Lab 2	Lab 3	Imaging 1	Imaging 2	Imaging 3
Lung abcess	Fever	Chest pain	night sweats	Dullness to percussion	coarse inspiratory crackles	Decreased breath sounds	Leukocytosis	Increased inflamatory markers (ESR, CRP)	Anemia of chronic disease	Frontal view of CXR showing lung abscess with air-fluid level. Case courtesy of Dr Abu-Rahmeh Zuhair (Picture courtesy: Radiopaedia)	Lateral view 0f CXR showing lung abscess with air-fluid level. Case courtesy of Dr Abu-Rahmeh Zuhair (Picture courtesy: Radiopaedia)	Non-contrast CT showing lung abscess with air-fluid levels. Case courtesy of Dr Elsayed Mohamed Elsayed (Picture courtesy: Radiopaedia)	H&E stain showing lung abscess. Arrowhead – pink necrotic tissue with necrotic granulocytes and bacteria. Arrow – chronic inflammatory cells and dilated blood vessels (Picture courtesy: Webpath)	CT with intravenous contrast
Thymic cyst	Cough	Chest pain	Dyspnea	Some patients may present with a soft compressible neck mass	-	-	-	-	-	x-ray scan showing a thymic mass (yellow arrowhead). Case courtesy of Dr. Stefan Ludwig (Picture courtesy: Radiopaedia)	CT scan showing a thymic mass corresponds to a cystic lesion (yellowarrow head). Case courtesy of Dr. Stefan Ludwig (Picture courtesy: Radiopaedia)	CT scan showing a calcified thymic mass corresponds to a cystic lesion (yellow arrowhead). Case courtesy of Dr Bruno Di Muzio (Picture courtesy: Radiopaedia)	H&E stain of thymic cyst showing bland squamous epithelium and some thymic tissue in its wall. Case courtesy of Dr Hanni Gulwani (Picture courtesy: Pathologyoutlines)	Biopsy withhistopathology and cytology
Esophageal duplication cysts	Retrosternal and thoracic back pain	Epigastric discomfort	Dysphagia	-	-	-	-	-	-	endoscopic view of an esophageal duplication cyst (Picture courtesy: Endoscopic ultrasound)	X-ray post barium swallow showing an oval mass compressing the esophagus. Case courtesy of Dr Michael P Hartung (Picture courtesy: Radiopaedia)	CT showing an esophageal duplication cyst. Case courtesy of Assoc Prof Craig Hacking (Picture courtesy: Radiopaedia)	Histologic image of an esophageal duplication cyst showing two-layered muscle coat like the GIT, and epithelium lining of pseudo-ciliated columnar cells. (Picture courtesy: National Center for Biotechnology Information)	Endoscopic ultrasound Anechoic or hypoechoic, homogenous lesions Regular margins originating from the submucosal layer or outside of the gut wall(adventitia)