Mediastinum - Bronchogenic cyst

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Mediastinum

Cystic lesions

Bronchogenic cyst

Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 23 February 2013, last major update December 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● Due to developmental defect from fusion of tracheoesophageal septum
● Along tracheobronchial tree, usually posterior to carina
● Usually asymptomatic

Epidemiology
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● Childhood or middle life

Clinical features
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● Usually symptomatic at diagnosis, complete excision is curative (Lung 2008;186:55)

Case reports
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● 30 year old man with bronchogenic cyst presenting as a thyroid mass (Head Neck Pathol 2011;5:416)
● 41 year old woman with carcinoid tumor arising in a thymic bronchogenic cyst associated with thymic follicular hyperplasia (Pathol Int 2012;62:49)

Xray description
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● Round/oval mass that molds to adjacent structures
● Wall may contain linear calcifications
● May have independent vascular supply

Clinical images
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Translucent round cyst behind descending aorta

Gross description
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● Unilocular or multilocular with internal septation; contain viscous or turbid fluid

Micro description
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● Resemble normal bronchi
● Lined by respiratory-type epithelium (pseudostratified columnar, often ciliated) with underlying fascicles of smooth muscle and mature cartilage
● No cholesterol granulomas
● May have extensive squamous metaplasia

Micro images
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Cyst wall with respiratory epithelium

Cyst lining has pseudostratified ciliated columnar epithelium

Bronchial-type seromucinous glands beneath epithelium

Differential diagnosis
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● Mature teratoma: see Am J Clin Pathol 2008;130:265

End of Mediastinum > Cystic lesions > Bronchogenic cyst

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