Tuberc Respir Dis.  2014 Feb;76(2):88-92. 10.4046/trd.2014.76.2.88.

Non-infected and Infected Bronchogenic Cyst: The Correlation of Image Findings with Cyst Content

• Jeon HG
• Park JH
• Park HM
• Kwon WJ
• Cha HJ
• Lee YJ
• Park CR
• Jegal Y
• Ahn JJ
• Ra SW

• KMID: 1877347
• DOI: http://doi.org/10.4046/trd.2014.76.2.88

Abstract

We hereby report a case on bronchogenic cyst which is initially non-infected, then becomes infected after bronchoscopic ultrasound (US)-guided transesophageal fine-needle aspiration (FNA). The non-infected bronchogenic cyst appears to be filled with relatively echogenic materials on US, and the aspirate is a whitish jelly-like fluid. Upon contrast-enhanced MRI of the infected bronchogenic cyst, a T1-weighted image shows low signal intensity and a T2-weighted image shows high signal intensity, with no enhancements of the cyst contents, but enhancements of the thickened cystic wall. The patient then undergo video-assisted thoracic surgery 14 days after the FNA. The cystic mass is known to be completely removed, and the aspirate is yellowish and purulent. To understand the image findings that pertain to the gross appearance of the cyst contents will help to diagnose bronchogenic cysts in the future.

Keyword

Bronchogenic Cyst; Ultrasonography; Magnetic Resonance Imaging; Infection

MeSH Terms

Biopsy, Fine-Needle
Bronchogenic Cyst*
Humans
Magnetic Resonance Imaging
Thoracic Surgery, Video-Assisted
Ultrasonography

Figure

• 

  Figure 1 (A) Baseline computed tomography image of the chest showing a round, right lower paraesophageal lesion, of 2.3 cm in diameter, with homogeneous and soft-tissue attenuation density (arrow). (B) Transesophageal ultrasound image showing a well-circumscribed homogeneous hypoechoic lesion with fine internal echoes and a smooth margin. (C) The cyst contents appear to be whitish and jelly-milk-like.

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  Figure 2 (A-C) Magnetic resonance images. (A) T1-weighted image (T1WI) showing low signal intensity (long arrow). (B) T2-weighted image (T2WI) showing heterogeneous high signal intensity (short arrow). (C) Under contrast enhancement, the cyst wall appears to be enhanced, but the cyst contents are not enhanced (arrowhead).

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  Figure 3 (A) Gross surgical specimen of the infected bronchogenic cyst with a yellowish turbid content. (B) Pathology slide showing a portion of the cyst wall with respiratory epithelium (arrow) that overlies the smooth muscle (H&E stain, ×20). (C) Epithelial denudation with infiltration of neutrophils and lymphocytes (H&E stain, ×200).

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