Clinical Spectrum of Mediastinal Cysts: Results

Between 1951 and 2000, 806 patients (451 male and 355 female) were referred to our institution for treatment of mediastinal tumors. There were 105 mediastinal cysts (50 male and 55 female patients), comprising 13.0% of total mediastinal tumors. There were 10 pediatric patients < 15 years of age and 95 adult patients (age range, 6 months to 74 years; average age, 37.3 years). The prevalence of cysts in all mediastinal tumors of the adult population was slightly higher than that in the pediatric population (14.1% vs 7.7%, p < 0.05). The details of mediastinal cysts are listed in Table 1.
There were 47 bronchogenic cysts (44.8%), 30 thymic cysts (28.6%), 12 pericardial cysts (11.4%), 7 pleural cysts (6.7%), 4 esophageal duplication cysts (3.8%), 2 meningoceles, 1 thoracic duct cyst, and 2 others. The mean ages of patients with bronchogenic/esophageal cysts, thymic cysts, and pericardial/ pleural cysts were 34.7, 43.9, and 37.5 years, respectively. Fifty-one of 105 mediastinal cysts (48.6%) were located in the middle mediastinum, followed by 35 cysts (33.3%) in the anterior and 19 cysts (18.1%) posterior mediastinum. In the current series, we used the term bronchogenic cyst in the mediastinum; therefore, bronchogenic cysts in the lung parenchyma seen in 13 patients were excluded from this study. http://buy-asthma-inhalers-online.com/

Regarding bronchogenic cysts, the classification of Maier was used to describe location. There were 12 right paratracheal, 4 left paratracheal, 11 right hilar, 5 left hilar, 7 subcarinal, 3 right paraesophageal, and 5 left paraesophageal bronchogenic cysts, as shown in Table 2.
Imaging and Diagnosis
Diagnostic evaluations in all cases began with conventional chest radiographs. Standard chest radiographs identified the mediastinal cysts in 94 patients (89.5%).
Table 1—Primary Mediastinal Cysts in Osaka University Hospital

Variables Adults Children Total Average Age, yr
Mediastinal tumors 676 130 806 35.5
Male 386 65 451
Female 290 65 355
Mediastinal cysts 95 10 105 37.3
Male 46 4 50
Female 49 6 55
% of tumors 14.1 7.7 13.0
Location
Anterior 34 1 35 (33.3)
Middle 45 6 51 (48.6)
Posterior 16 3 19(18.1)
Malignancy 0(0) 0 (0) 0 (0)
Bronchogenic 41 6 47 35.3
cyst
Thymic cyst 29 1 30 43.9
Pericardial cyst 12 0 12 39.4
Pleural cyst 5 2 7 34.7
Esophageal cyst 3 1 4 28.3
Meningocele 2 0 2 43.0
Others 3 0 3 38.7

Table 2—Anatomic Location of Mediastinal Bronchogenic Cysts

Locations Adults, n = 41 Pediatric (0 to 15 yr), n = 6 Total, n = 471
Right paratracheal 11 1 12
Left paratracheal 3 1 4
Right hilar 9 2 11
Left hilar 4 1 5
Subcarinal 7 0 7
Right paraesophageal 3 0 3
Left paraesophageal 4 1 5
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