CONGENITAL LUNG MALFORMATIONS

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CONGENITAL LUNG MALFORMATIONS

Presentation transcript:

CONGENITAL LUNG MALFORMATIONS Bronchogenic cyst

Bronchogenic cysts are foregut duplication cysts. They may be MEDIASTINAL, INTRAPULMONARY or less frequently CERVICAL. MEDIASTINUM (85%) SUBCARINAL(most common), precarinal, paratracheal, esophagic wall Can be associated to spinal anomalies. Do not communicate with airway (air only if infection) INTRAPULMONARY (uncommon) lower lobes/middle third Can communicate with airway and then see an air-fluid level.

Bronchogenic cyst Clinical notes Infants: respiratory distress or dysphagia Older children: chest pain and dysphagia and vomiting Mass effect, more common in mediastinal lesions Consider in children with recurrent infection In adults can be asymptomatic

Mediastinal bronchogenic cyst: plain chest film features Well-defined mass with smooth borders. Soft tissue density. Carinal location is the most frequent but also paratracheal hiliar or central lung (tipically) Mediastinal bronchogenic cyst: plain chest film features

Mediastinal (subcarinal) bronchogenic cyst: CT findings Homogenous well circumscribed lesion Cyst contents: water to Proteinaceous Nonenhancing or minimal enhancing wall Do not communicate with airway and do not contain air (unless infection) Mediastinal (subcarinal) bronchogenic cyst: CT findings

Intrapulmonary bronchogenic cyst Conversely mediastinal, intrapulmonary bronchogenic cysts can communicate with airway and present an air-fluid level Intrapulmonary bronchogenic cyst

Intrapulmonary bronchogenic cyst with an air-fluid level simulating an infected bulla