A case report of para-esophageal bronchogenic cyst with esophageal communication

Abstract

Paraesophageal bronchogenic cyst was one of common mediastinal congenital cystic lesions of foregut origin. Because of an intimate embryologic relationship with the esophagus, they were usually found intramural (intramural esophageal bronchogenic cysts) with the local esophageal mucosa being intact and the paraesophageal bronchogenic cysts were rarely communicated with esophageal lumen. We report a case of para-esophageal bronchogenic cyst communicating to the esophageal lumen thorough a pedicle of canal, which looked liked a diverticulum on X-ray. During the operation, a communication of paraesophageal bronchogenic cyst with esophageal was found and the pathology diagnosis were made then. The symptoms of chest pain and dysphagia were relieved immediately after operation. The follow-up was well 2 years after the surgery.

Figure 1

(a) A barium swallowrevealed a huge pare-esophagealcyst cavity compressed toesophagus,and also communicated toesophagus through a longentrance. (b) The chest CT scans showed a huge cystic mass full of gas and liquid located in the post-mediastinum with a direct compression of the pericardium, esophagus and right lung.

Figure 2

Uper endoscopy revealed ano ulcero-necrotical entrance (1.5 cm × 1.0) on theright anterior wall ofthe esophageal at 36 cm from scior teeth,where the local mucosaare smooth and thoroughly (seethe arrow).

Figure 3

Complete remove of thepara-esophageal cyst through aright poster-lateral thoractomy. (a) Gross appearance of the resected cyst. (b) The entrance on the esophagus was sutured in two layers. The arrow points the pedicle after suture.

Figure 4

The pathology examination ofthe cystic wall showedbronchogenic tissue including respiratoryciliated columnar epithelium (a,HE,×100), smooth muscle andCartilage (b, HE,×40)