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Gonzalez J, Batlle JC, Maroules C, Cury RC, Peña CS, Ma C, Menes M, Sayegh K. Multimodality imaging of a rare intracardiac bronchogenic cyst. Radiol Case Rep 2024; 19:1035-1039. [PMID: 38226045 PMCID: PMC10788368 DOI: 10.1016/j.radcr.2023.11.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 11/28/2023] [Indexed: 01/17/2024] Open
Abstract
The authors report a case of pathologically proven intracardiac bronchogenic cyst embedded within the interatrial septum of a 30-year-old woman presenting with chest pain and first-degree AV block. Multimodality imaging played an essential role in the discovery, investigation, and diagnosis of this extremely rare entity.
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Affiliation(s)
- Jeffrey Gonzalez
- Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th St, Miami, FL 33199 Miami, FL, USA
| | - Juan C. Batlle
- Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th St, Miami, FL 33199 Miami, FL, USA
- Baptist Health of South Florida, 8900 N Kendall Dr, Miami, FL, 33176 USA
- Radiology Associates of South Florida, 8900 N Kendall Dr, Miami, FL, 33176 USA
| | - Christopher Maroules
- Baptist Health of South Florida, 8900 N Kendall Dr, Miami, FL, 33176 USA
- Radiology Associates of South Florida, 8900 N Kendall Dr, Miami, FL, 33176 USA
| | - Ricardo C. Cury
- Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th St, Miami, FL 33199 Miami, FL, USA
- Baptist Health of South Florida, 8900 N Kendall Dr, Miami, FL, 33176 USA
- Radiology Associates of South Florida, 8900 N Kendall Dr, Miami, FL, 33176 USA
| | - Constantino S. Peña
- Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th St, Miami, FL 33199 Miami, FL, USA
- Baptist Health of South Florida, 8900 N Kendall Dr, Miami, FL, 33176 USA
- Radiology Associates of South Florida, 8900 N Kendall Dr, Miami, FL, 33176 USA
| | - Charles Ma
- Baptist Health of South Florida, 8900 N Kendall Dr, Miami, FL, 33176 USA
| | - Manuel Menes
- Baptist Health of South Florida, 8900 N Kendall Dr, Miami, FL, 33176 USA
| | - Karl Sayegh
- Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th St, Miami, FL 33199 Miami, FL, USA
- Baptist Health of South Florida, 8900 N Kendall Dr, Miami, FL, 33176 USA
- Radiology Associates of South Florida, 8900 N Kendall Dr, Miami, FL, 33176 USA
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Phan AT, Hu J, Oganesian B, Williams SO. Symptomatic Bronchogenic Cyst in a Lipomatous Interatrial Septum. Cardiol Res 2023; 14:315-318. [PMID: 37559710 PMCID: PMC10409548 DOI: 10.14740/cr1511] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 06/01/2023] [Indexed: 08/11/2023] Open
Abstract
Intracardiac bronchogenic cysts are extremely rare congenital anomalies that arise during foregut development when the embryologic heart tube and ventral foregut are in close proximity to one another. We report a case of an interatrial septal bronchogenic cyst found on non-contrast enhanced computed tomography (CT) in a 66-year-old female who presented to the emergency department with chest pain. Further cardiac investigations, including contrast-enhanced CT angiogram of the heart, transthoracic echocardiogram, and transesophageal echocardiogram, revealed a cystic mass in the lipomatous interatrial septum. The patient was subsequently diagnosed with a bronchogenic cyst of the interatrial septum. No surgical intervention was pursued, as the mass remained stable, and the cardiothoracic surgeon did not recommend excision. This case highlights a rare case of a symptomatic bronchogenic cyst arising in the interatrial septum diagnosed by imaging modalities. Bronchogenic cysts should be included in the differential diagnosis of intracardiac tumors.
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Affiliation(s)
- Alexander T. Phan
- Department of Internal Medicine, Arrowhead Regional Medical Center, Colton, CA 92324, USA
| | - Janie Hu
- Department of Internal Medicine, Arrowhead Regional Medical Center, Colton, CA 92324, USA
| | - Buzand Oganesian
- Department of Internal Medicine, Arrowhead Regional Medical Center, Colton, CA 92324, USA
| | - Shammah O. Williams
- Department of Cardiology, Arrowhead Regional Medical Center, Colton, CA 92324, USA
- Department of Cardiology, Loma Linda University, Loma Linda, CA 92305, USA
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Mora A, Ghavamrezaii A, Abidali H, Caballero H, Hamidullah A, Mitzov N. Mediastinal Bronchogenic Cyst With Superior Vena Cava Syndrome: A Case Report. Cureus 2023; 15:e42040. [PMID: 37593276 PMCID: PMC10431947 DOI: 10.7759/cureus.42040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 08/19/2023] Open
Abstract
Bronchogenic cysts are rare in adults and often remain undetected until discovered incidentally on imaging or during a symptomatic investigation. The possibility of superior vena cava (SVC) compression due to a bronchogenic cyst arises in complex patient presentations. SVC syndrome poses several unique challenges due to the wide range of clinical symptoms and difficulty identifying the cause when symptoms first manifest. This case report examines a 39-year-old male who presented with symptoms resulting from SVC compression caused by a bronchogenic cyst, leading to SVC syndrome. We discuss the various imaging modalities used to assess the severity of the obstruction and the surgical interventions employed to alleviate the symptoms. A surgical intervention provides symptomatic relief and promises an excellent prognosis when performed without complications.
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Affiliation(s)
- Annalee Mora
- Internal Medicine, Oak Hill Hospital, Brooksville, USA
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Garg S, Aggarwal K, Anamika F, Kumar A. Hydropneumothorax: A Presentation of Infected Bronchogenic Cyst. Cureus 2023; 15:e38569. [PMID: 37284403 PMCID: PMC10239548 DOI: 10.7759/cureus.38569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2023] [Indexed: 06/08/2023] Open
Abstract
Bronchogenic cysts are closed sac-like cystic lesions resulting from abnormal budding of the primitive foregut during the early development of the alimentary and respiratory systems. We describe the case of a 54-year-old man who presented to the emergency department with complaints of fever, chills, shortness of breath, and a productive cough with intermittent hemoptysis for the past two to three months. Initial workup revealed a right lung hydropneumothorax with complete atelectasis of the right lung and a mass effect on the left lung. During intercostal drainage, pleural fluid analysis revealed empyema with E. coli treated with antibiotics. However, the symptoms persisted after five days of antibiotic treatment and drainage. A multidisciplinary team of thoracic surgeons, anesthesiologists, and pulmonologists was assembled due to the non-resolving nature of the lung abscess. The patient underwent a right middle lobe lobectomy with decortication via open thoracotomy, and a bronchogenic cyst, an uncommon cause of the lung abscess, was suggested by histopathological analysis.
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Affiliation(s)
- Shreya Garg
- Internal Medicine, Dayanand Medical College and Hospital, Ludhiana, IND
| | - Kanishk Aggarwal
- Internal Medicine, Dayanand Medical College and Hospital, Ludhiana, IND
| | - Fnu Anamika
- Internal Medicine, University College of Medical Sciences, New Delhi, IND
| | - Avi Kumar
- Respiratory Medicine, Fortis Escorts Heart Institute, New Delhi, IND
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Fukudome Y, Hieda M, Masui S, Yokoyama T, Futami S, Moriyama S, Irie K, Fukata M, Ushijima T, Shiose A, Akashi K. Case Report: Bronchogenic Cyst in the Right Atrium of a Young Woman. Front Cardiovasc Med 2022; 9:915876. [PMID: 35711360 PMCID: PMC9197382 DOI: 10.3389/fcvm.2022.915876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/02/2022] [Indexed: 12/03/2022] Open
Abstract
A 31-year-old woman was referred to our hospital for evaluation of a cardiac mass in the right atrium. Cardiac magnetic resonance imaging indicated a cystic mass filled with fluid accumulation in the right atrium. The mass was identified as a cardiac cyst and was surgically removed. Pathological examination revealed an extremely rare bronchogenic cyst. Bronchogenic cysts are benign congenital abnormalities of primitive foregut origins that form in the mediastinum during embryonic development. There is unusual clinical dilemmas surrounding the treatment plan for cardiac surgery or biopsy of cardiac masses, especially in patients with rare cardiac cysts. The anatomical location of the cyst can be related to various clinical symptoms and complications. In cases of indeterminate cardiac cysts, direct cyst removal without prior biopsy is of utmost importance.
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Affiliation(s)
- Yuya Fukudome
- Heart Center, Kyushu University Hospital, Fukuoka, Japan
| | - Michinari Hieda
- Department of Medicine and Bio-systemic Science, Hematology, Oncology, and Cardiovascular Medicine, School of Medicine, Kyushu University Hospital, Fukuoka, Japan
- *Correspondence: Michinari Hieda,
| | - Shiho Masui
- Department of Medicine and Bio-systemic Science, Hematology, Oncology, and Cardiovascular Medicine, School of Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Taku Yokoyama
- Department of Medicine and Bio-systemic Science, Hematology, Oncology, and Cardiovascular Medicine, School of Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Shutaro Futami
- Department of Medicine and Bio-systemic Science, Hematology, Oncology, and Cardiovascular Medicine, School of Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Shohei Moriyama
- Department of Medicine and Bio-systemic Science, Hematology, Oncology, and Cardiovascular Medicine, School of Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Kei Irie
- Department of Medicine and Bio-systemic Science, Hematology, Oncology, and Cardiovascular Medicine, School of Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Mitsuhiro Fukata
- Department of Medicine and Bio-systemic Science, Hematology, Oncology, and Cardiovascular Medicine, School of Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Tomoki Ushijima
- Department of Cardiovascular Surgery, Kyushu University Hospital, Fukuoka, Japan
| | - Akira Shiose
- Department of Cardiovascular Surgery, Kyushu University Hospital, Fukuoka, Japan
| | - Koichi Akashi
- Department of Medicine and Bio-systemic Science, Hematology, Oncology, and Cardiovascular Medicine, School of Medicine, Kyushu University Hospital, Fukuoka, Japan
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Ghigna MR, Thomas de Montpreville V. Mediastinal tumours and pseudo-tumours: a comprehensive review with emphasis on multidisciplinary approach. Eur Respir Rev 2021; 30:30/162/200309. [PMID: 34615701 PMCID: PMC9488622 DOI: 10.1183/16000617.0309-2020] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 01/08/2021] [Indexed: 12/02/2022] Open
Abstract
The diagnosis of a mediastinal mass may be challenging for clinicians, since lesions arising within the mediastinum include a variety of disease entities, frequently requiring a multidisciplinary approach. Age and sex represent important information, which need to be integrated with imaging and laboratory findings. In addition, the location of the mediastinal lesion is fundamental; indeed, we propose to illustrate mediastinal diseases based on the compartment of origin. We consider that this structured approach may serve as hint to the diagnostic modalities and management of mediastinal diseases. In this review, we present primary mediastinal tumours in the evolving context of new diagnostic and therapeutic tools, with recently described entities, based on our own experience with >900 cases encountered in the past 10 years. Given the mediastinal anatomical heterogeneity, the correct positioning of mediastinal lesions becomes primal, in order to first establish a clinical suspicion and then to assist in planning biopsy and surgical procedurehttps://bit.ly/3p0gsk3
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Affiliation(s)
- Maria-Rosa Ghigna
- Dept of Pathology, Marie Lannelongue Hospital, Le Plessis Robinson, France
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