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Weekly Chest CasesArchive of Old Cases

Case No : 1102 Date 2018-12-10

  • Courtesy of Eun Young Kim, Hee Young Lee / Gachon University Gil Medical Center
  • Age/Sex 46 / F
  • Chief ComplaintNo specific symptom
  • Figure 1
  • Figure 2
  • Figure 3

Diagnosis With Brief Discussion

Diagnosis
Bronchogenic cyst
Radiologic Findings
Fig 1. Chest PA shows a mass in the left posterior mediastinum.
Fig 2-3. Pre and postcontrast CT images show a 2-cm sized ovoid nodular lesion (mean attenuation: 37HU on precontrast CT, 50HU on postcontrast CT) in the left posterior mediastinum (laterally abutting the descending thoracic aorta).

Mediastinum, posterior, excision; Benign cyst, consistent with bronchogenic cyst
Brief Review
• • Known as foregut malformations; congenital anomalies caused by abnormal budding of the tracheobronchial tree.
• Discovered at any age, usually < 35years.
• A stalk or pedicle commonly attaches the cyst to a mediastinal structure. May be associated with other congenital anomalies of lung development, such as sequestration, lobar emphysema, and diaphragmatic hernia
• Imaging findings: Most commonly occur in the subcarina and right paratracheal regions. Usually manifest as smooth, well-marginated mediastinal mass on radiographs and CT. Typically homogeneous and approximately half are of water attenuation and half are of soft tissue attenuation due to intra-cystic hemorrhage or proteinaceous debris.
• Those of soft tissue attenuation may still be characterized as cystic if layering milk of calcium is present or shows homogeneous enhancement with no central enhancement and a thin wall.
References
1. Bronchogenic Cyst: Imaging Features with Clinical and Histopathologic Correlation, H. Page McAdams et el, Radiology 2000; 217:441–446
Keywords
Lung, Developmental,

No. of Applicants : 66

▶ Correct Answer : 33/66,  50.0%
  • - Ishikawa Matto Central Hospital , Japan MANABU AKIMOTO
  • - Showa University Fujigaoka Hospital , Japan KYOKO NAGAI
  • - Niigata University , Japan ATSUSHI UEHARA
  • - , United Kingdom SAMSON K
  • - McGill University Health Center , Canada Alexandre Semionov
  • - Chonbuk National University Hospital , Korea (South) SANGHEON KIM
  • - Ondokuz Mayis University , Turkey CETIN CELENK
  • - Chungbuk National University Hospital , Korea (South) JIYUN KANG
  • - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
  • - 罹…stanbul , Turkey AYHAN YILMAZ
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - The Jikei university , Japan TAKU GOMI
  • - Ajou University Hospital , Korea (South) Taeyang Ha
  • - Other , Korea (South) JIYEON HAN
  • - Gifu University Hospital , Japan Yo Kaneko
  • - Seoul National University Hospital , Korea (South) JI HEE KANG
  • - Samsung Medical Center , Korea (South) MIN YEONG KIM
  • - The University of Tokyo Hospital , Japan RYO KUROKAWA
  • - Chonbuk National University Hospital , Korea (South) YOUNGKWANG LEE
  • - Samsung Medical Center , Korea (South) KYOWON GU
  • - Kyung Hee University Medical Hospital , Korea (South) JUNHYUNG LEE
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey MERIC TUZUN
  • - Chonbuk National University Hospital , Korea (South) KUM JU CHAE
  • - , Korea (South) JANG SEONG WON
  • - Columbia asia refferal hospital,Bengaluru , India PRAVIN KUMAR M
  • - University of New South Wales , Australia RASHID HASHMI
  • - Teikyo University Hospital , Japan KAORU SUMIDA
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - Samsung Changwon Hospital , Korea (South) DONG SU KIM
  • - College of Medicine, CHA University , Korea (South) PARK JONG WON
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
  • - Seoul Veterans Hospital , Korea (South) HYUN JUNG YOON
  • - Jiangsu province hospital , China WANGJIAN ZHA
▶ Correct Answer as Differential Diagnosis : 17/66,  25.8%
  • - Kinki University Faculty of Medicine, , Japan MITSURU MATSUKI
  • - Other , Korea (South) SEONGSU KANG
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - Mallinckrodt Institute of Radiology , United States Naganathan BS Mani
  • - CLINIQUE STE CLOTILDE , Reunion PATRICK MASCAREL
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - Avrasya Hospital/ISTANBUL , Turkey MURAT ULUSOY
  • - , Japan NAOMI YUASA
  • - Chungbuk national university hospital , Korea (South) Miran Yeon Yeon
  • - Korea University Guro Hospital , Korea (South) KYU-CHONG LEE
  • - Fortis hospital , Mohali , India SHALEEN RANA
  • - Kizawa Memorial Hospital , Japan Shoji Okuda
  • - Kyoto Prefectural University of Medicine , Japan TADASHI TANAKA
  • - Hamamatsu University Hospital , Japan YUKI HAYASHI
  • - Diagnose.me (BV) / Royal Perth Hospital , Australia YURANGA WEERAKKODY
  • - Chonnam National University Hwasun Hospital , Korea (South) JONG EUN LEE
  • - Ajou University Hospital , Korea (South) YONG HO JANG
▶ Semi-Correct Answer : 2/66,  3.0%
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - ZIGONG TCM HOSPITAL OF CHINA , China Cao Cunyou
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Current Editor : Sung Shine Shim, MD, PhD. Email : sinisim@ewha.ac.kr

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