[Clinical and pathological features of congenital bronchial cyst].

OBJECTIVE

To study the clinical and pathological features of congenital bronchial cysts.

METHODS

The clinical, X-ray, CT and histopathologic manifestations were retrospectively reviewed in 30 patients with congenital bronchial cysts.

RESULTS

There were 23 patients with intrapulmonary bronchogenic cysts, 5 patients with mediastinal bronchogenic cysts, and 2 patients with ectopic bronchogenic cysts. Of the 30 patients, 18 were liquid cysts, 7 air cysts, and 5 multiple pulmonary cysts. Intrapulmonary congenital bronchial cysts were diagnosed always due to infection. Nineteen of 23 patients (83%) presented with cough, sputum production, 2 accompanied by fever, 11 with hemoptysis or blood-stained sputum, 11 with chest pain. The imaging features were "bag included mass", which was characterized by a big bag surrounded by a little soft-tissue, or thin walled cavity, or multiple honeycomb or cystoid circular translucency. Two of 4 patients with mediastinal bronchogenic cysts incidentally discovered on a radiograph obtained for other reasons were almost asymptomatic, 2 presented with dyspnea due to compression of trachea, 1 with dysphagia due to compression of oesophagus. The imaging features included isolated well-defined round shape or ovoid soft-tissue mass with isodensity, and mutual compression between the surrounding organs. Two patients with ectopic bronchogenic cysts were diagnosed due to cystic mass on chest wall. Pseudostratified ciliated columnar epithelium, gland, cartilage, elastic fiber and smooth muscle were all confirmed by light microscopy.

CONCLUSIONS

The main type of congenital bronchial cysts is intrapulmonary bronchogenic cysts. The clinical manifestations are cough, sputum production and hemoptysis, and the imaging feature is "bag included mass" on CT scan. A lining of respiratory epithelium associated with a wall containing glands, cartilage and smooth-muscle is the histopathologic feature for diagnosing congenital bronchial cysts. The optimal treatment is surgical resection.