Clinical Spectrum of Mediastinal Cysts: Patients with bronchogenic cysts
Symptomatic patients were seen in 39.2% with bronchogenic/ esophageal cysts, 40% with thymic cysts, and 15.8% with pericardial/pleural cysts, respectively. Asymptomatic patients were most common in patients with mesothelial cysts compared to type of cysts (p = 0.06).
In the current study, the prevalence of symptomatic patients with bronchogenic/esophageal foregut cysts was lower than that reported previously, ranging from 50 to 80%.6Д1’ In addition, symptoms of infection such as fevers in the current series were low (9.8%) in patients with bronchogenic or esophageal cysts in the mediastinum compared to previous reports.” In our experience, 10 of 13 patients (79%) with parenchymal bronchogenic cysts had symptoms of infection, including 1 patient with a tuberculosis infection in the cyst, and this incidence was consistent with previous reports.
St-Georges and coworkers reported that 90% of parenchymal bronchogenic cysts had symptoms of infection compared to mediastinal bronchogenic cysts with 36.4%. In addition, two pediatric patients with parenchymal bronchogenic cysts had symptoms of respiratory distress associated with acute mediastinal shift due to a ballooning of the cyst, and emergency left lower lobectomy was performed. We only encountered the following acute symptoms in two patients with mediastinal bronchogenic cysts: one patient appeared with empyema due to cyst rupture, and the an patient referred to us with abrupt onset of hoarseness due to ballooning of a right paratracheal cyst (this hoarseness was reversible by surgery). According to Ribet and colleagues, bronchogenic cysts in the subcarinal or paratracheal locations were more apt to provoke compression symptoms. Children with narrow or soft airways are easily vulnerable to compression by expanding cysts; therefore, patients with bronchogenic cysts in the pediatric group were seen as life-threatening emergencies, but this was also seen in adult patients.