Eur J Cardiothorac Surg 2003;23:104
© 2003 Elsevier Science NL
Images in cardio-thoracic surgery |
Compression of the central airways by a bronchogenic cyst
Theodosios Dosios*,
Spyros Spyrakos
Second Department of Propaedeutic Surgery, Division of Thoracic Surgery, Laiko Hospital, University of Athens, Athens, Greece
Received 16 September 2002;
accepted 1 October 2002.
* Corresponding author. 2 Chatzigianni Mexi Str., 11528 Athens, Greece. Tel.: +30-10-7247-000; fax: +30-10-7247-000
e-mail: dosiosth{at}internet.gr
Key Words: Bronchogenic cyst • Bronchial asthma • Pressure on central airways • Surgical treatment
A 27-year-old woman had been complaining of wheezing and dyspnoea on exertion, non-productive cough and recurrent respiratory infections and had been treated for bronchial asthma since the age of 2. A recent chest radiogram showed a mediastinal shadow. Computed tomography scanning and magnetic resonance imaging (MRI) (Fig. 1)
revealed a 6.3x5.4 cm homogeneous, cystic mediastinal mass causing compression and stenosis of the central airways.
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Fig. 1. Coronal (A); axial (B) T2-weighted; and sagital (C) T1-weighted MRI at the level of the tracheal bifurcation (Tr=trachea, RBr=right main-stem bronchus, LBr=left main-stem bronchus, Car=carina, and SVC=superior vena cava).
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In surgery a cyst containing a milky fluid, lying mainly in front of the distal trachea and partially under and behind the carina, was found. The cyst was resected totally. Histopathological examination showed a bronchogenic cyst. The postoperative course was uneventful. Thirty months after discharge the patient is completely asymptomatic with no medication and her chest radiogram is normal.
