Imaging: Bronchogenic Cyst

1. Dr. Teffy Jose
Prof.Dr.DHANDAPANI’S UNIT

2. 45 yr old , Mr.Ibrahim ,came with
c/o
2 months cough with expectoration
1 episode of hemoptysis
o/e
afebrile
PR- 82/mt
BP-120/80 mmhg
CVS –S1 S2 +
RS -clear

4. CXR –PA view; Adequate penetration ;
Trachea in midline ;
Bone and soft tissues normal;
‘well defined smooth bordered radio opaque lesion seen in
the left lower zone with lobular contour ‘
‘lateral superior &inferior borders are well defined ‘
‘left heart border is seen through the opacity ‘
‘descending thoracic aorta is obscured by the opacity
IMP; suggestive of homogenous opacity
located posteriorly

6. The lateral x ray confirmed the posterior location of the
opacity
X ray wise this could thought of as a mediastinal mass /
solitary pulmonary opacity > 4 cm size the diff.diag of
which is
_bronchial carcinoma
_lung abscess
_wegener’s granulomatosis
_lymphoma
_round pneumonia

8. Ct picture

11. CT shows:

7*7.5*6 cm sized lobulated non enhancing cystic
density lesion of 0-25 HU noted in posterobasal
segment of left lower lobe.
The lesion shows surrounding consolidatory changes
with air bronchogram
IMP:Infected bronchogenic cyst with consolidation in
the left lower lobe

13. Bronchogenic cyst
“During development a portion of the tracheo bronchial tree
gets separated “
Can be ----- a)pulmonary b) mediastinal
10-15% 65-90%
Radiology ;
sharply demarcated round /oval, nodule /mass,
usually in the medial 1/3 of lungs
with a lower lobe predilection
usually don’t communicate with the tracheobronchial
tree unless infected

14. Ct findings
Non enhancing homogenous opacity
With attenuation density approximately of water 0-20
HU
With smooth thin wall
Sometimes the density may be high due to varied
contents with high protein or calcium
MRI is superior to CT in diagnosing

15. Mediastinal bronchogenic cysts
five types
-paratracheal
-carinal
-hilar
-paraeosophageal
-miscellaneous
-thymus,pericardium etc ,

16. Clinical picture
Usually asymptomatic
When infected may present with cough and sputum
production
Hemoptysis is also a common presenting feature
Rarely complications like
pneumothorax
air emoblism
adenocarcinoma

17. Thank
you