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The Annals of Thoracic Surgery, Vol 52, 6-13, Copyright © 1991 by The Society of Thoracic Surgeons
R St-Georges, J Deslauriers, A Duranceau, R Vaillancourt, C Deschamps, G Beauchamp, A Page and J Brisson
Bronchogenic cysts are closed sacs considered to be the result of an
abnormal budding of the respiratory system. They are lined by ciliated
epithelium and have focal areas of hyaline cartilage, smooth muscle, and
bronchial glands within their walls. They are seldom seen in the adult, and
most are thought to be asymptomatic and free of complications. During a
20-year period, 86 patients underwent resection of a bronchogenic cyst of
the mediastinum (66 patients) and lung (20 patients). There were 47 women
and 39 men whose ages ranged from 16 to 69 years. Seventy-two percent of
patients (67% with mediastinal cysts and 90% with cysts of the lung) were
symptomatic at the time of operation, and the majority had two or more
symptoms. Despite extensive investigations, which in some cases included
computed tomographic scanning (n = 12) and angiography (n = 22), a positive
diagnosis was never made preoperatively even if it was suspected in 57% of
patients. In nearly all patients, the operative approach was that of a
posterolateral thoracotomy. All but two mediastinal bronchogenic cysts
could be locally excised, but all bronchogenic cysts of the lung required
pulmonary resection (lobectomy, 13; limited resection, 6; pneumonectomy,
1). Major operative difficulties were encountered in 35 patients, all of
whom were symptomatic preoperatively. Thirty-three patients had a
complicated cyst; the complications consisted of fistulization (n = 16),
ulcerations of the cyst wall (n = 13), hemorrhage (n = 2), infection
without fistulization (n = 1), and secondary bronchial atresia (n = 1).
Overall, 82% of patients had a bronchogenic cyst that was either
symptomatic or complicated or both.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Clinical spectrum of bronchogenic cysts of the mediastinum and lung in the adult
Centre de Pneumologie de Laval, Hopital Laval, Ste-Foy, Canada.
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