J Korean Soc Radiol.  2012 Apr;66(4):347-351. 10.3348/jksr.2012.66.4.347.

Anterior Mediastinal Bronchogenic Cysts Manifesting as a Solid Mass: A Report of Three Cases

• Yoo SH
• Ham SY
• Choi EJ
• Oh YW
• Kim KT
• Kim CW

• KMID: 2208848
• DOI: http://doi.org/10.3348/jksr.2012.66.4.347

Abstract

Bronchogenic cysts are congenital malformations that are thought to develop from abnormal budding of the embryonic foregut. They are most commonly seen in the mediastinum, especially in the middle and the posterior mediastinum, and they typically show water-attenuation. Anterior mediastinal bronchogenic cyst is extremely rare. Anterior mediastinal bronchogenic cysts with soft-tissue attenuation have not been reported in the English-language literature up until now. We discovered 3 cases of anterior mediastinal well-circumscribed lesions showing soft-tissue attenuation which were diagnosed as thymoma preoperatively, but were later identified as bronchogenic cysts on pathology.

MeSH Terms

Bronchogenic Cyst
Mediastinum
Thymoma

Figure

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  Fig. 1 Bronchogenic cyst in a 43-year-old asymptomatic man. Transverse view of non-contrast enhanced chest CT scan (mediastinal window settings) (A) shows a well-circumscribed homogenous soft-tissue attenuated (ROI = 35 HU, SD = 19.15) lesion (arrow) in the anterior mediastinum. On microscopy (H&E, × 400) (B), the cyst is lined with pseudostratified ciliated columnar epithelium and is without cartilage and smooth muscle components.

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  Fig. 2 Bronchogenic cyst in a 46-year-old asymptomatic woman. Transverse pre-contrast enhanced CT scan (mediastinal window settings) shows a 3.2 cm sized well-circumscribed soft-tissue attenuated (ROI = 23 HU) lesion (arrow) in the anterior mediastinum (A). This lesion shows homogenous attenuation which is less than that for soft tissue. After contrast enhancement, slight thin-wall enhancement is noted. Internal enhancement is not significant (arrow) (B).

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  Fig. 3 Bronchogenic cyst in a 65-year-old woman with chest pain. Transverse pre-contrast enhanced CT scan (mediastinal window settings) (A) shows a 2-cm well-circumscribed soft-tissue attenuated (ROI = 57 HU, SD = 45.60) lesion (arrow) in the anterior mediastinum. This lesion shows homogenous attenuation similar to that of soft tissue. In contrast-enhanced CT scan, internal enhancement is not seen (arrow) (B). On microscopy [H&E, × 40 (C) and × 400 (D)], the cyst is lined with pseudostratified ciliated columnar epithelium, and is without cartilage and smooth muscle components.

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