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The Annals of Thoracic Surgery, Vol 53, 1134-1137, Copyright © 1992 by The Society of Thoracic Surgeons
JW Bolton and DM Shahian
The management of patients with uncomplicated bronchogenic cysts has
evolved over the last decade with the development of more precise
diagnostic techniques and a better understanding of the variable natural
history of these lesions. Although an aggressive surgical approach is still
indicated for infants and children, it is acceptable to treat asymptomatic
bronchogenic cysts in adults in a conservative manner. Observation alone
may be indicated for small, classic, asymptomatic cysts. The use of
mediastinoscopy or percutaneous or transbronchial needle techniques for
carinal or paratracheal cysts offers the option of fluid aspiration or wall
biopsy, thus avoiding thoracotomy. An air-fluid level in the cyst, the
presence of malignant cells in the aspirate or biopsy, the development of
symptoms, or enlargement or recurrence of the cyst on follow-up examination
mandates complete surgical removal at thoracotomy. This is also indicated
for intraparenchymal bronchogenic cysts, which are more prone to bronchial
communication and infectious complications and for which the distinction
from a carcinoma with a cystic component may be difficult.
ARTICLES
Asymptomatic bronchogenic cysts: what is the best management?
Department of Thoracic and Cardiovascular Surgery, Lahey Clinic Medical Center, Burlington, Massachusetts 01805.
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