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.
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to the Circulation Editorial Office, St Luke’s Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.