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Chul Kim, M.D.1, Yang Ki Kim, M.D.1, Young Mok Lee, M.D.1
, Ki-Up Kim, M.D.1, Hyun Zo Kim, M.D.2, Jung Hwa Hwang, M.D.3, Dong Won Kim, M.D.4, Soo-Taek Uh, M.D.1
, Ki-Up Kim, M.D.1, Hyun Zo Kim, M.D.2, Jung Hwa Hwang, M.D.3, Dong Won Kim, M.D.4, Soo-Taek Uh, M.D.1
Abstract
Bronchogenic cyst arises from anomalous budding of the primitive foregut during embryonic development and it represents a part of the spectrum of bronchopulmonary foregut malformations. Approximately two-thirds of the malformations are found within the mediastinum, and one-third are found in the lung parenchyma. The prevalence of bronchogenic cyst is unknown, presumably because most patients are asymptomatic. Incidentally detected bronchogenic cysts are usually removed at the time of diagnosis. We do not know how and why bronchogenic cysts grow. We recently experienced a case of rapidly growing mediastinal mass in a young adult, and this presented as a huge mass that had newly developed within one year. This mass was pathologically confirmed to be a bronchogenic cyst. We report on this case of a rapidly growing bronchogenic cyst, which is a rare characteristic of this type of cyst.
Figures and Tables
Figure 1
Chest PA finding of 20 year old male at first visit and 1 year ago, well defined mass like opacity was showed at subcarinal area which was almost fist size of child (A). However 1 year ago, the mass was not detected (B).
Figure 2
Chest computed tomography of the presented male. There was about 5.6×4.8×7 cm sized, well defined, cystic mass at right subcarinal area. Bronchus intermedius of right lung was compressed by the cystic mass.
Figure 3
Bronchoscopic finding of right bronchus intermedius, posterior wall of the bronchus was bulged by extrinsic compression, but mucosal wall looked intact.
Figure 4
Gastroscopy (A) and endoscopic ultrasound (B) findings of the presented male, there was an indentation of esophagus at 25~32 cm from incisor (arrow). Endoscopic ultrasound showed about 6.6 cm sized hypoechoic cyst. Echogenic material of the inside of cyst was changed their location by position (arrow head).
Figure 5
Gross and microscopic findings after surgical excision from the presented male. A brown red colored unilocular cyst was measured 6×4×1 cm. Wall of the cyst looked grossly smooth and spherical fibrotic tissue which was accompanied multiple and focal hemorrhage (A). Microscopic finding demonstrated a cyst wall which had contained airway components such as cartilage plate and smooth muscle (B, ×40). Magnified photograph showed single layer of ciliated columnar epithelium as like bronchial epithelium with goblet cells (C, H&E stain, ×200).
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