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(Circulation. 2002;106:e209.)
© 2002 American Heart Association, Inc.

Images in Cardiovascular Medicine

Bronchogenic Cyst

Acute Presentation

R.F.J. Browne, MD, FFRRCSI; S. Fitzgerald, MD, MRCPI; V. Young, MD, FRCS, (C.Th.), FRCSI; B. Hogan, MD, FRCR; D. Moore, MD, FRCPI

Department of Radiology (R.F.J.B., B.H.), Cardiology (S.F., D.M.), The Adelaide and Meath Hospital, Tallaght, and Department of Cardiothoracic Surgery (V.Y.), St James’s Hospital, Dublin, Ireland.

Correspondence to Dr R.F.J. Browne, Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland. E-mail ronanbrowne@hotmail.com

An extract of the first 250 words of the full text is provided, because this article has no abstract.

A 41-year-old man presented with acute retrosternal pain radiating to the back. The suspected diagnosis was dissecting thoracic aortic aneurysm. Chest radiograph was normal. Computed tomography showed a well-defined subcarinal loculated mass of low density compressing the superior vena cava and ascending aorta anteriorly and the esophagus posteriorly (Figure 1). Transthoracic and transesophageal echocardiography revealed a 7-cm posterior cystic mass almost completely obliterating the left atrium and associated with a small pericardial effusion (Figure 2 and Figure 3). Complete surgical resection of the mass was performed without complication. Histological examination of resected tissue revealed ciliated stratified epithelium characteristic of a bronchogenic cyst (Figure 4). The patient remains asymptomatic 18 months after surgery.

View larger version (47K): [in this window] [in a new window]   Figure 1. A, Contrast enhanced computed tomographic (CT) scan of the thorax showing a well-defined 7-cm subcarinal mass (curved arrow) of predominantly fluid attenuation with wall enhancement. The superior vena cava (short arrow) and ascending aorta (long arrow) are compressed anteriorly by the mass, and the esophagus is compressed posteriorly. B, The loculated nature of the mass is demonstrated on a higher image (arrow).

View larger version (91K): [in this window] [in a new window]   Figure 2. Parasternal long axis transthoracic echocardiogram showing an echodense mass (arrow) apparently within the posterior left atrium (LA). There is a small posterior pericardial effusion. LV indicates left ventricle; AO, aorta.

View larger version (129K): [in this window] [in a new window]   Figure 4. Fibrotic cyst wall lined by partially stratified epithelium with some cilia in keeping with a bronchogenic cyst.

View larger version (99K): [in this window] [in a new window]   Figure 3. Midesophageal long axis transesophageal echocardiogram (TOE) image showing the large thick-walled echodense mass (arrow) posterior . . . [Full Text of this Article]