Bronchogenic cyst

Case contributed by Abdulrahman Abdo Ali Abbas

Presentation

3 months old female presented with tachypnea and respiratory distress, she has past history of recurrent attacks of respiratory distress, fever, and cough.

Patient Data

Age: 3 months
Gender: Female
x_ray

Hyperinflation of the entire left lung with trans-herniation of left lung to the right side along with mediastinal shift.

ct

A well-defined cystic lesion is seen in the middle mediastinum between the trachea and esophagus with the inferior part of the lesion compressing the left main bronchus resulting in hyperinflation of the entire left lung, trans-herniating of the left lung to the right side with a contralateral mediastinal shift.

Case Discussion

A bronchogenic cyst is a rare congenital malformation of the lung, it is rarely reported in infants. Symptoms usually start in adulthood, it is rare for the bronchogenic cyst to manifest in newborn or infant.

Mediastinal bronchogenic cyst in children is often responsible for compressive symptoms of the tracheobronchial tree and may have a similar appearance with the congenital lobar emphysema on the chest x-ray.

It is important in all cases of suspected congenital lobar emphysema, obstructive causes must be ruled out and the  CT scan can reveal the cause of obstruction in most of the cases.

In cases where the main bronchus is compressed, the entire lung becomes hyperinflated.

 The management in obstructive lobar emphysema secondary to the bronchogenic cyst involves surgical excision of cysts, unlike CLE where lobectomy will be needed. 

Postoperative chest radiograph after surgical excision of the bronchogenic cyst ensures the resolution of the hyperinflation of the left lung with the return of mediastinum to normal position. 

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