Correct!
1. Bronchogenic cyst

As noted previously, the cross sectional imaging findings indicate an indolent-appearing, incidentally discovered cyst in the subcarinal space. Renal cell malignancies can occasionally appear necrotic, even cystic, and can manifest as isolated mediastinal lesions. However, this patient has no active or previous renal malignancy, and even prominently cystic or necrotic renal cell carcinoma metastases usually show some solid, enhancing areas; the latter are lacking in this patient. The lesion’s location is unusual for pericardial cysts (typically anteriorly located in the right >left cardiophrenic angle), Müllerian duct (aka Hattori) cysts (typically posterior- superior mediastinum in women), and thoracic duct cysts (posterior mediastinum, connected to the thoracic duct). However, the lesion’s location in the subcarinal space is the most common location for a bronchogenic cyst, which also is the most common cause of a cystic middle mediastinal lesion.

Diagnosis: Bronchogenic cyst

References

  1. Shin KE, Yi CA, Kim TS, Lee HY, Choi YS, Kim HK, Kim J. Diffusion-weighted MRI for distinguishing non-neoplastic cysts from solid masses in the mediastinum: problem-solving in mediastinal masses of indeterminate internal characteristics on CT. Eur Radiol. 2014;24(3):677-84. [CrossRef] [PubMed]
  2. Jain A, Anand K, Singla S, Kumar A. Congenital cystic lung diseases. J Clin Imaging Sci. 2013; 3:5. [CrossRef] [PubMed]
  3. Ballouhey Q, Galinier P, Abbo O, Andrieu G, Baunin C, Sartor A, Rittié JL, Léobon B. The surgical management and outcome of congenital mediastinal malformations. Interact Cardiovasc Thorac Surg. 2012;14(6):754-9. [CrossRef] [PubMed]
  4. Laberge JM, Puligandla P, Flageole H. Asymptomatic congenital lung malformations. Semin Pediatr Surg. 2005;14(1):16-33. [CrossRef] [PubMed]
  5. Berrocal T, Madrid C, Novo S, Gutiérrez J, Arjonilla A, Gómez-León N. Congenital anomalies of the tracheobronchial tree, lung, and mediastinum: embryology, radiology, and pathology. Radiographics. 2004;24(1):e17. [CrossRef] [PubMed]

Home/Imaging