Bronchogenic cyst

Case contributed by Ammar Ashraf
Diagnosis certain


Smoker with dry cough for one year. No fever, night sweats, anorexia or weight loss.

Patient Data

Age: 35 years
Gender: Male

Sizable well-defined homogeneous non-calcified soft tissue density mass in the subcarinal middle and posterior mediastinum, causing splaying of the carina. Clear both lungs.


A well-defined thin-walled cystic lesion measuring about 5.0 x 5.0 x 5.0 cm is seen in the subcarinal posterior mediastinum. It has an average density of about 25 HU, minimal peripheral enhancement and mild mass effect over the esophagus. No septations, calcifications, or solid component is seen in it.

Postoperative day 1


Mild right basal atelectatic changes, surgical emphysema in the soft tissues of the right lateral chest wall and right lower neck and minimal right apical pneumothorax. Right-sided chest tube seen in place. 

5 weeks later


Status post excision of subcarinal mediastinal lesion. Post-operative changes have also resolved. 

Well-defined subcarinal posterior mediastinal cystic lesion, which is likely a bronchogenic cyst; possible differential diagnosis includes esophageal duplication cyst and pericardial cyst.

Case Discussion

The patient underwent excision of the sbcarinal mediastinal cystic lesion via video-assisted thoracoscopic surgery (VATS). 

Gross: Specimen consists of multiple fragments of cyst wall measuring in aggregate 3.0 x 2.0 cm and 0.4 cm in thickness. Sectioning shows grey-red soft hemorrhagic cut surface.

Microscopy: Sections show cyst wall lined by ciliated pseudo-stratified columnar to cuboidal cells and within the wall there are scattered mucinous glands, fibrosis, smooth muscles and scattered lymphoid follicles.   

Diagnosis: Bronchogenic cyst.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.