Prenatal Diagnosis and Postnatal Findings of Bronchogenic Cyst

Abstract

Bronchogenic cysts arise from abnormal buds from the primitive esophagus and tracheobronchial tree, which do not extend to the site where alveolar differentiation occurs. Bronchogenic cysts are typically unilocular mucus field lesions arising from posterior membranous wall of the air way. The prenatal diagnosis usually is realized by two-dimensional ultrasound showing the large unilocular cystic image in the chest fetus. The prenatal percutaneous aspiration can reduce the risk of heart compression and permit better respiratory conditions to newborn. We present a case of a primiparous pregnant 23 year-old-woman prenatal ultrasound showed a large unilocular cyst in the left hemithorax with compression of the normal left lung tissue and contralateral mediastinal shift. This cyst was percutaneously aspirated without subsequent reaccumulation of fluid. The newborn did not have respiratory distress and the computed tomography scan confirmed the finding of a fluid-filled cyst in the left chest. The chest X-ray showed the displacement of the heart and the mediastinum from the left to the right. The prenatal diagnosis of bronchogenic cyst is very important to assess the degree of the compression of the normal lung and the mediastinum shift. Furthermore, the prenatal diagnosis permits planning delivery in the tertiary hospital with multidisciplinary team because of the risk of respiratory distress.

Thoracoscopic resection of a bronchogenic cyst in a 17-year-old girl

“…Mediastinal cysts are usually unilocular, well-demarcated, lined with ciliated columnar epithelium, and filled with mucous content [3, 6–8]. They originate from disturbances in the embryonic evolution of the primitive esophagus and tracheobronchial tree [7]. Mediastinal cysts can cause typical symptoms such as cough, hoarseness, dysphagia, dyspnea, pneumonia, bronchitis, superior vena cava syndrome, arrhythmia, or Horner’s syndrome [3, 8].…”

“…Mediastinal cysts can cause typical symptoms such as cough, hoarseness, dysphagia, dyspnea, pneumonia, bronchitis, superior vena cava syndrome, arrhythmia, or Horner’s syndrome [3, 8]. Less frequently reported complications include rupture and intracystic bleeding, infection of the cystic content, pneumothorax resulting from the rupture of a cyst communicating with the respiratory tract, as well as the extremely rare malignant transformation of the tumor [3, 7]. The occurrence and severity of the symptoms are related primarily to the location of the tumor and, to a lesser extent, to its size.…”

“…Large cysts can cause pressure on the mediastinal organs of the fetus, pulmonary hypoplasia, or cardiac disorders, which in turn may result in generalized edema and fetal death. During the neonatal period, the main risk associated with the presence of cysts is breathing disorders that can lead to acute respiratory failure [7]. …”

A case of right ventricular bronchogenic cyst with the clinical presentation of cerebral infarction and pulmonary embolism

“…The location of the bronchogenic cyst can be explained by embryogenesis [1]. Bronchogenic cyst arises from abnormal buds from the primitive esophagus and tracheobronchial tree, which do not extend to the site where alveolar differentiation occurs.…”

“…A bronchogenic cyst is a congenital malformation of the bronchial tree [1]. The cyst usually developed in the mediastinum or lung [2,3].…”