The majority of patients with bronchogenic [[cyst]] are [[asymptomatic]] and are diagnosed during investigations for other pathologies.<ref name="pmid17859095">{{cite journal| author=Maier HC| title=Bronchiogenic Cysts of the Mediastinum. | journal=Ann Surg | year= 1948 | volume= 127 | issue= 3 | pages= 476-502 | pmid=17859095 | doi=10.1097/00000658-194803000-00010 | pmc=1513836 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17859095 }} </ref><ref name="pmid31462259">{{cite journal| author=Yang X, Zong Y, Zhao HY, Wu YD, Ji M| title=Complete excision of esophageal bronchogenic cyst by endoscopic submucosal tunnel dissection: a case presentation. | journal=BMC Gastroenterol | year= 2019 | volume= 19 | issue= 1 | pages= 155 | pmid=31462259 | doi=10.1186/s12876-019-1072-3 | pmc=6714396 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31462259 }} </ref><ref name="pmid480084">{{cite journal| author=Ramenofsky ML, Leape LL, McCauley RG| title=Bronchogenic cyst. | journal=J Pediatr Surg | year= 1979 | volume= 14 | issue= 3 | pages= 219-24 | pmid=480084 | doi=10.1016/s0022-3468(79)80474-1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=480084 }} </ref>
The majority of patients with bronchogenic [[cyst]] are [[asymptomatic]] and are diagnosed during investigations for other pathologies.
When symptomatic, clinical presentation of bronchogenic [[cyst]] depends on the age of the patient, size and the location of the [[cyst]].<ref name="pmid17859095">{{cite journal| author=Maier HC| title=Bronchiogenic Cysts of the Mediastinum. | journal=Ann Surg | year= 1948 | volume= 127 | issue= 3 | pages= 476-502 | pmid=17859095 | doi=10.1097/00000658-194803000-00010 | pmc=1513836 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17859095 }} </ref><ref name="pmid25746696">{{cite journal| author=Jiang JH, Yen SL, Lee SY, Chuang JH| title=Differences in the distribution and presentation of bronchogenic cysts between adults and children. | journal=J Pediatr Surg | year= 2015 | volume= 50 | issue= 3 | pages= 399-401 | pmid=25746696 | doi=10.1016/j.jpedsurg.2014.06.008 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25746696 }} </ref>
When symptomatic, the clinical presentation of bronchogenic [[cyst]] depends on the age of the patient, size and the location of the [[cyst]].
'''In infants bronchogenic cyst presents with'''
'''In infants bronchogenic cyst presents with''' <ref name="pmid19015445">{{cite journal| author=Teissier N, Elmaleh-Bergès M, Ferkdadji L, François M, Van den Abbeele T| title=Cervical bronchogenic cysts: usual and unusual clinical presentations. | journal=Arch Otolaryngol Head Neck Surg | year= 2008 | volume= 134 | issue= 11 | pages= 1165-9 | pmid=19015445 | doi=10.1001/archotol.134.11.1165 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19015445 }} </ref><ref name="pmid8651761">{{cite journal| author=Ribet ME, Copin MC, Gosselin BH| title=Bronchogenic cysts of the lung. | journal=Ann Thorac Surg | year= 1996 | volume= 61 | issue= 6 | pages= 1636-40 | pmid=8651761 | doi=10.1016/0003-4975(96)00172-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8651761 }} </ref><ref name="pmid27986331">{{cite journal| author=Hsu CG, Heller M, Johnston GS, Felberbaum M| title=An Unusual Cause of Airway Compromise in the Emergency Department: Mediastinal Bronchogenic Cyst. | journal=J Emerg Med | year= 2017 | volume= 52 | issue= 3 | pages= e91-e93 | pmid=27986331 | doi=10.1016/j.jemermed.2016.11.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27986331 }} </ref><ref name="pmid25746696">{{cite journal| author=Jiang JH, Yen SL, Lee SY, Chuang JH| title=Differences in the distribution and presentation of bronchogenic cysts between adults and children. | journal=J Pediatr Surg | year= 2015 | volume= 50 | issue= 3 | pages= 399-401 | pmid=25746696 | doi=10.1016/j.jpedsurg.2014.06.008 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25746696 }} </ref><ref name="pmid27822780">{{cite journal| author=Lin JS, Yu YR, Chiou EH, Chumpitazi BP, Schady DA, Brandt ML| title=Intramural esophageal bronchogenic cyst mimicking achalasia in a toddler. | journal=Pediatr Surg Int | year= 2017 | volume= 33 | issue= 1 | pages= 119-123 | pmid=27822780 | doi=10.1007/s00383-016-3994-y | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27822780 }} </ref><ref name="pmid26112048">{{cite journal| author=Thaller P, Blanchet C, Badr M, Mesnage R, Leboucq N, Mondain M | display-authors=etal| title=Neonatal respiratory distress syndrome revealing a cervical bronchogenic cyst: a case report. | journal=BMC Pediatr | year= 2015 | volume= 15 | issue= | pages= 72 | pmid=26112048 | doi=10.1186/s12887-015-0363-2 | pmc=4491209 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26112048 }} </ref><ref name="pmid29099998">{{cite journal| author=Brugha R, Semple T, Cook J, Dusmet M, Rosenthal M| title=Two Bronchogenic Cysts Causing Tracheal Stenosis in an Infant. | journal=Am J Respir Crit Care Med | year= 2018 | volume= 197 | issue= 2 | pages= 261-262 | pmid=29099998 | doi=10.1164/rccm.201708-1611IM | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29099998 }} </ref>
*[[respiratory distress]]
*[[respiratory distress]]
*Increasing [[stridor]]
*Increasing [[stridor]]
Line 92:
Line 91:
'''In children and adults, bronchogenic cyst presents with'''
'''In children and adults, bronchogenic cyst presents with'''
*Dull [[chest pain]],<ref name="pmid17859095">{{cite journal| author=Maier HC| title=Bronchiogenic Cysts of the Mediastinum. | journal=Ann Surg | year= 1948 | volume= 127 | issue= 3 | pages= 476-502 | pmid=17859095 | doi=10.1097/00000658-194803000-00010 | pmc=1513836 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17859095 }} </ref><ref name="pmid12809250">{{cite journal| author=Sarper A, Ayten A, Golbasi I, Demircan A, Isin E| title=Bronchogenic cyst. | journal=Tex Heart Inst J | year= 2003 | volume= 30 | issue= 2 | pages= 105-8 | pmid=12809250 | doi= | pmc=161894 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12809250 }} </ref><ref name="pmid27068723">{{cite journal| author=Chumakova M, Morris-Stiff G, Khachaturov V, Ibrahim S| title=Bronchogenic cyst arising from the crus of the left hemidiaphragm. | journal=BMJ Case Rep | year= 2016 | volume= 2016 | issue= | pages= | pmid=27068723 | doi=10.1136/bcr-2015-213658 | pmc=4840741 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27068723 }} </ref><ref name="pmid26986156">{{cite journal| author=Han C, Lin R, Yu J, Zhang Q, Zhang Y, Liu J | display-authors=etal| title=A Case Report of Esophageal Bronchogenic Cyst and Review of the Literature With an Emphasis on Endoscopic Ultrasonography Appearance. | journal=Medicine (Baltimore) | year= 2016 | volume= 95 | issue= 11 | pages= e3111 | pmid=26986156 | doi=10.1097/MD.0000000000003111 | pmc=4839937 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26986156 }} </ref> with radiation to the shoulder in diaphragmatic broncogenic [[cyst]].<ref name="pmid25131363">{{cite journal| author=Legras A, Mordant P, Gibault L, Hernigou A, Le Pimpec Barthes F, Riquet M| title=[Diaphragmatic bronchogenic cyst: an exceptional location]. | journal=Rev Pneumol Clin | year= 2014 | volume= 70 | issue= 6 | pages= 357-61 | pmid=25131363 | doi=10.1016/j.pneumo.2014.05.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25131363 }} </ref><ref name="pmid27986331">{{cite journal| author=Hsu CG, Heller M, Johnston GS, Felberbaum M| title=An Unusual Cause of Airway Compromise in the Emergency Department: Mediastinal Bronchogenic Cyst. | journal=J Emerg Med | year= 2017 | volume= 52 | issue= 3 | pages= e91-e93 | pmid=27986331 | doi=10.1016/j.jemermed.2016.11.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27986331 }} </ref>
*Dull [[chest pain]] with radiation to the shoulder in diaphragmatic broncogenic [[cyst]].
*[[Cough]]<ref name="pmid26986156">{{cite journal| author=Han C, Lin R, Yu J, Zhang Q, Zhang Y, Liu J | display-authors=etal| title=A Case Report of Esophageal Bronchogenic Cyst and Review of the Literature With an Emphasis on Endoscopic Ultrasonography Appearance. | journal=Medicine (Baltimore) | year= 2016 | volume= 95 | issue= 11 | pages= e3111 | pmid=26986156 | doi=10.1097/MD.0000000000003111 | pmc=4839937 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26986156 }} </ref> <ref name="pmid12809250">{{cite journal| author=Sarper A, Ayten A, Golbasi I, Demircan A, Isin E| title=Bronchogenic cyst. | journal=Tex Heart Inst J | year= 2003 | volume= 30 | issue= 2 | pages= 105-8 | pmid=12809250 | doi= | pmc=161894 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12809250 }} </ref><ref name="pmid30846076">{{cite journal| author=Ayub II, Balakrishnan H, Arshad AM, Manimaran N, Thangaswamy D, Chockalingam C| title=A 44-Year-Old Man With Nonproductive Cough and Sensation of Heaviness Over the Upper Chest. | journal=Chest | year= 2019 | volume= 155 | issue= 3 | pages= e65-e68 | pmid=30846076 | doi=10.1016/j.chest.2018.09.035 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30846076 }} </ref>
*[[Cough]]
*Progressive [[dysphagia]]<ref name="pmid17859095">{{cite journal| author=Maier HC| title=Bronchiogenic Cysts of the Mediastinum. | journal=Ann Surg | year= 1948 | volume= 127 | issue= 3 | pages= 476-502 | pmid=17859095 | doi=10.1097/00000658-194803000-00010 | pmc=1513836 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17859095 }} </ref><ref name="pmid26986156">{{cite journal| author=Han C, Lin R, Yu J, Zhang Q, Zhang Y, Liu J | display-authors=etal| title=A Case Report of Esophageal Bronchogenic Cyst and Review of the Literature With an Emphasis on Endoscopic Ultrasonography Appearance. | journal=Medicine (Baltimore) | year= 2016 | volume= 95 | issue= 11 | pages= e3111 | pmid=26986156 | doi=10.1097/MD.0000000000003111 | pmc=4839937 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26986156 }} </ref>
*Progressive [[dysphagia]]
*[[Odynophagia]]<ref name="pmid26986156">{{cite journal| author=Han C, Lin R, Yu J, Zhang Q, Zhang Y, Liu J | display-authors=etal| title=A Case Report of Esophageal Bronchogenic Cyst and Review of the Literature With an Emphasis on Endoscopic Ultrasonography Appearance. | journal=Medicine (Baltimore) | year= 2016 | volume= 95 | issue= 11 | pages= e3111 | pmid=26986156 | doi=10.1097/MD.0000000000003111 | pmc=4839937 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26986156 }} </ref>
Bronchogenic cyst is a rare benigncongenital malformation of the tracheobronchial tree derived from the ventral aspect of the foregut. It most frequently occurs in the middle mediastinum, in the early stages of gestation or in the lungs, at the later stages of gestation. Atypical locations may be explained by its embryologic origin.
Patients with bronchogenic cyst may be asymptomatic or present with respiratory distress, increasing stridor, feeding difficulties, chest pain, cough, progressive dysphagia, odynophagia, purulent sputum, dyspnea, anorexia and/orweight loss.
Radiologic findings are useful to differentiate bronchogenic cysts from other cysts but may they not always confirm the diagnosis. Diagnosis is confirmed by surgical excision, which is curative, and histological findings of ciliated columnar epithelial lining of the cyst.
Historical Perspective
There is limited information about the historical perspective of bronchogenic cyst.
Classification
Bronchogenic cyst can be classified based on location; pulmonary and extrapulmonary.[1][2]
Pathophysiology
It is thought that bronchogenic cyst is the result of abnormal budding of the ventral portion of the primitive foregut between days 26 - 40 of gestation.
Causes
The cause of bronchogenic cysts is undetermined.
Differentiating Bronchogenic cyst from other Diseases
Bronchogenic cyst epidemiology and demographics|Epidemiology and Demographics
There is no racial predilection to bronchogenic cyst. Bronchogenic cyst is slightly more prevalent in men and often remain undetected until the third or fourth decade of life.
Risk factors
There are no established risk factors for bronchogenic cyst.
Screening
There is insufficient evidence to recommend routine screening for bronchogenic cyst as it is usually an incidental finding.
Natural history, complications and prognosis
Natural History
The symptoms of bronchogenic cyst usually develop in the third to fourth decade of life and start with symptoms such as
The majority of patients with bronchogenic cyst are asymptomatic and are diagnosed during investigations for other pathologies.
When symptomatic, the clinical presentation of bronchogenic cyst depends on the age of the patient, size and the location of the cyst.
In infants bronchogenic cyst presents with
An elevated serum tumor makers CA125 and CA19-9, which is usually suggestive of progression/complication.
CT
CT scan may be helpful in the diagnosis of bronchogenic cyst. The density of bronchogenic cysts is variable from water density to high density due to blood, anthracotic pigment, increased calcium content, or increased protein content of the fluid. Findings on CT scan suggestive of bronchogenic cyst is an
ovoid and well-defined encapsulated low-density cystic mass with no contrast enhancement.
Thin subtle walls.
MRI
MRI may be helpful in the diagnosis of bronchogenic cyst. After contrast injection, enhancement of the cyst is frequently absent. Findings on MRI suggestive of bronchogenic cyst include
T1-weighted images show ipointense signal
T2-weighted images show hyperintense signal.
Ultrasound
ultrasound may be helpful in the diagnosis of bronchogenic cyst. Finding on an ultrasound suggestive of bronchogenic cyst include
On endobronchial ultrasound, an anechoic or hypoechoic fluid-filled solid mass.
On transthoracic echocardiography revealing intracardiac cystic mass.