1. CONGENITAL LUNG MALFORMATIONS
Bronchogenic cyst

2. 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.

3. 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

4. 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

5. 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

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

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