Bronchogenic cysts mimicking thymoma in the anterior mediastinum

Abstract

Bronchogenic cysts are commonly located in the middle mediastinal compartment as fluid-filled cysts and thymoma is one of the most common neoplasms in the anterior mediastinum in adult cases. For two cases of asymptomatic, incidentally discovered anterior mediastinal soft tissue mass in adults, we planned to perform complete thymectomy with minimally invasive techniques based on the guidelines of International Thymic Malignancy Interest Group. Their pathological finding revealed cystic lesions lined by ciliated epithelium and this supported the diagnosis of bronchogenic cyst rather than thymic neoplasm. We report the two cases of resected bronchogenic cysts which were in the unusual location of anterior mediastinum with uncommon radiological feature.

Intrathymic growing bronchogenic cyst mimicking thymoma: A case report

“…Most of the bronchogenic cysts are located in the posterior mediastinum or intrapulmonary since they derived from abnormal germination of the embryonic foregut ( 4 ). The first bronchogenic thymic cyst was reported by Taniwaki in 1997, and there are less than 10 cases reported nowadays in the literature ( 5 ). Unusual locations of bronchogenic cysts were reported in skin, subcutaneous tissue, neck, mesentery of bowel, or the intramedullary part of the spine ( 1 ).…”

A cyst in the mist: bronchogenic mediastinal cysts

“…The commonest cystic lesions in the anterior mediastinum are pericardial (9%) and thymic (13%) in origin [ 4 ]. Although rare, BMC can be symptomatic due to cyst infection or compression of nearby structures, leading to respiratory distress and cough [ 8 ]. These cysts have a small chance of becoming malignant if left untreated [ 9 ].…”

“…These cysts have a small chance of becoming malignant if left untreated [ 9 ]. Contrast CT chest is the investigation of choice for suspected BMC, presenting as homogenous, smooth round masses on the middle mediastinum with rare incidence of calcification [ 5 , 8 ]. Interestingly in this case, the contrast CT thorax demonstrated a large, slightly lobulated, oval-shaped right anterior mediastinal mass with the appearance suggesting a cystic density with patchy calcification in the capsule wall.…”

“…The cyst wall had focal hyaline fibrosis and calcification and contained smooth muscle, bronchial mucous glands and cartilage and lined by ciliated and non-ciliated columnar to cuboidal epithelium, in keeping with BMC. Our patient represents a rare case of BMC due to the presentation and location [ 8 ]. Cases of BMC have been reported in literature with majority looking at the mediastinal subtype [ 10 ].…”

A tiny intrathymic bronchogenic cyst detected by continually boosting chest pain following COVID-19 mRNA vaccine administration

“…Bronchogenic cysts are uncommon congenital cystic lesions, and anterior mediastinal and intrathymic bronchogenic cysts are extremely rare. 1 We present a case of a patient who complained of chest pain induced by COVID-19 vaccinations and ended up incidentally discovering an intrathymic bronchogenic cyst on a CT scan during diagnosis. A 40-year-old male was referred to our outpatient department due to the incidental finding of a trivial thymic lesion during a survey regarding chest pain bouts after COVID-19 vaccine administration.…”