Bronchogenic cysts are small, solitary cysts or sinuses, most typically located in the region of the

suprasternal notch The suprasternal notch, also known as the fossa jugularis sternalis, jugular notch, or Plender gap, is a large, visible dip in between the neck in humans, between the clavicles, and above the manubrium of the sternum. Structure The suprasternal ...

or behind the

manubrium The sternum or breastbone is a long flat bone located in the central part of the chest. It connects to the ribs via cartilage and forms the front of the rib cage, thus helping to protect the heart, lungs, and major blood vessels from injury. Sh ...

Clinical features

These cysts are found most often in young adults and are rare in

infancy An infant or baby is the very young offspring of human beings. ''Infant'' (from the Latin word ''infans'', meaning 'unable to speak' or 'speechless') is a formal or specialised synonym for the common term ''baby''. The terms may also be used to ...

. The usual symptoms are the result of compression by the cyst, e.g., difficulty breathing or swallowing, cough, and chest pain. Malignant degeneration has been reported in these cysts on rare occasions. Bronchogenic cysts are usually found in the middle

mediastinum The mediastinum (from ) is the central compartment of the thoracic cavity. Surrounded by loose connective tissue, it is an undelineated region that contains a group of structures within the thorax, namely the heart and its vessels, the esophagu ...

. Chest x-rays show a smooth density just in front of the

trachea The trachea, also known as the windpipe, is a cartilaginous tube that connects the larynx to the bronchi of the lungs, allowing the passage of air, and so is present in almost all air-breathing animals with lungs. The trachea extends from th ...

or main stem bronchi at the carinal level. When the cyst communicates with the tracheobronchial tree, the air-fluid level may be seen within the cyst.

CT scanning A computed tomography scan (CT scan; formerly called computed axial tomography scan or CAT scan) is a medical imaging technique used to obtain detailed internal images of the body. The personnel that perform CT scans are called radiographers ...

is useful in localizing these cysts.

Pathology

Bronchogenic cysts are formed in the 6th week of

gestation Gestation is the period of development during the carrying of an embryo, and later fetus, inside viviparous animals (the embryo develops within the parent). It is typical for mammals, but also occurs for some non-mammals. Mammals during preg ...

from an abnormal budding of the tracheal

diverticulum In medicine or biology, a diverticulum is an outpouching of a hollow (or a fluid-filled) structure in the body. Depending upon which layers of the structure are involved, diverticula are described as being either true or false. In medicine, t ...

. They are lined by respiratory type (ciliated) epithelium, which is characterized by

cilia The cilium, plural cilia (), is a membrane-bound organelle found on most types of eukaryotic cell, and certain microorganisms known as ciliates. Cilia are absent in bacteria and archaea. The cilium has the shape of a slender threadlike projecti ...

. Histologically these are also composed of cartilage,

smooth muscle Smooth muscle is an involuntary non- striated muscle, so-called because it has no sarcomeres and therefore no striations (''bands'' or ''stripes''). It is divided into two subgroups, single-unit and multiunit smooth muscle. Within single-unit ...

, fibrous tissue and mucous glands. These cysts originate from the ventral foregut that forms the respiratory system. These cysts are located close to the

or main stem

bronchi A bronchus is a passage or airway in the lower respiratory tract that conducts air into the lungs. The first or primary bronchi pronounced (BRAN-KAI) to branch from the trachea at the carina are the right main bronchus and the left main bronch ...

. Rarely there is communication of the cyst with the tracheobronchial tree.

Treatment

* Excision provides definitive diagnosis and cure. *

Biopsy A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, or an interventional cardiologist. The process involves extraction of sample cells or tissues for examination to determine the presence or extent of a d ...

provides a definitive diagnosis with less surgical risk. *

Observation Observation is the active acquisition of information from a primary source. In living beings, observation employs the senses. In science, observation can also involve the perception and recording of data via the use of scientific instruments. Th ...

provides minimal risk from the intervention, but carries some risk of bleeding or infection of the cyst at a later time, making excision more difficult if it occurs.

Additional images

Image:Cilia light micrograph.jpg, Very high magnification light micrograph showing the

of a bronchogenic cyst.

H&E stain Hematoxylin and eosin stain ( or haematoxylin and eosin stain or hematoxylin-eosin stain; often abbreviated as H&E stain or HE stain) is one of the principal tissue stains used in histology. It is the most widely used stain in medical diagnos ...

References

{{reflist Cutaneous congenital anomalies

Clinical features

Pathology

Treatment

Additional images

See also

References