Ann Thorac Surg 2006;81:e31
© 2006 The Society of Thoracic Surgeons
Images in cardiothoracic surgery
An Infected Intrapulmonary Bronchogenic Cyst
Chau-Chyun Sheu, MD
a
,
*
,
Reu-Sheng Sheu, MD, PhD
b
,
Yu-Jen Cheng, MD
c
a Division of Pulmonary and Critical Care Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
b Department of Radiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
c Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
* Address correspondence to Dr Sheu, Division of Pulmonary and Critical Care Medicine, Kaohsiung Medical University Hospital, 100 Shih-Chuan 1st Rd, Kaohsiung, 807 Taiwan (Email: sheu{at}kmu.edu.tw).
A 32-year-old woman came to our hospital for chest pain. She claimed to enjoy good health until 1 year before her presentation to our hospital. Her chest pain was located in the right anterior chest and was characterized by persistence of tightness. She also complained of a chronic productive cough, and the sputum turned to be purulent in recent days. The physical examination was unremarkable. The chest roentgenogram demonstrated a thin-walled cyst (9.5 x 11.5 cm in size) with air-fluid level over the right hilum (Fig 1A). An infected bronchogenic cyst was suspected. However, she was lost to follow-up until 1 year later when she complained that the right-sided chest pain and productive cough were both in progress. There was usually a copious amount of sputum when she was lying in the left lateral decubitus position. In addition, she had exertional dyspnea in recent months, and she had become febrile for the last 3 days. A decreased breath sound over the right lung was found on physical examination. The chest roentgenogram demonstrated that the previous cystic lesion was enlarged (11.5 x 14 cm in size) with air-fluid level (Fig 1B). The three-dimensional computed tomographic scan demonstrated a huge cyst in the right lung, with a communication between the cyst and the bronchus (Figs 1C, 1D). After the infection was under control, she underwent resection of the cystic lesion by video-assisted thoracoscopic surgery. On pathologic examination, the cyst was lined with respiratory epithelium and the submucosal glands were presented. A diagnosis of intrapulmonary bronchogenic cyst was established. She was doing well after the surgery, with no more chest pain, productive cough, or exertional dyspnea.
