A Right Paratracheal Air Cyst Caused by Tracheal Diverticula

Abstract

A 65-year-old

Paratracheal air cysts: Prevalence and correlation with lung diseases using multi‐detector CT

“…In our study, which contained the largest number of patients evaluated thus far, we observed PACs in 4.0% of the patient group. In some cases, PACs may be symptomatic due to a local mass effect and direct compression, resulting in clinical manifestations such as a chronic cough, repeated episodes of respiratory infections, haemoptysis, stridor, dysphagia, chest‐neck and/or right clavicle pain or dyspnoea . Rarely, a large diverticulum can compress the recurrent laryngeal nerve and result in dysphonia .…”

“…To avoid confusing PACS and pneumomediastinum, in our study, we excluded patients who had undergone tracheotomy, intubation, sternotomy and trauma. In addition to pneumomediastinum, differential considerations for PACs include pharyngocele, laryngocele, Zenker diverticulum, apical lung hernia, blebs and bulla . Contrast esophogram and cervical and thoracic CT are useful, non‐invasive examinations for narrowing the differential diagnostic considerations in these patients.…”

“…Tracheal diverticula and bronchial diverticula may similarly be generated from mucosal herniation through a weakened tracheobronchial wall due to chronic inflammation and increased luminal pressure . Congenital or acquired forms of tracheal diverticula have also been described . Although the former is thought to be the result of supernumerary, malformed branches of the trachea, the latter is thought to be due to increased intraluminal pressure caused by COPD .…”

Variations of the tracheobronchial tree: Anatomical and clinical significance

“…This was followed by Chiari's 1889 description of six autopsies with diverticula at the lower end of the trachea on the right side (MacKinnon, ). Present day sources describe a tracheal diverticulum as a benign entity characterized by single or multiple outpouchings of the tracheal wall (Sato et al, ). According to an autopsy series of 867 specimens, MacKinnon () estimated an overall prevalence of tracheal diverticula at about 1%.…”

“…In contrast, acquired tracheal diverticula appear laterally between the cartilaginous rings or posterolaterally through the trachealis muscle (Restrepo et al, ; Desir and Ghaye, ; Sato et al, ). The more common posterolateral diverticula are usually located on the right side at the level of the thoracic inlet (Restrepo et al, ; Desire and Ghaye, ; Sato et al, ). The development of acquired tracheal diverticula is the result of mucosal herniation through a weak point in the tracheal wall (Goo et al, ).…”