Bronchogenic cysts are congenital cysts found in the chest cavity, often discovered incidentally during medical imaging. Surgery may be necessary if the cyst poses a risk of rupture or infection, but many people live with them without issue.
A bronchogenic cyst is a congenital cyst, typically found in the central area of the chest cavity. Many people live with bronchogenic cysts their entire lives and are unaware of it, while others may experience symptoms that lead to a diagnosis. Most commonly, the cyst is an incidental finding on a medical imaging study done for another purpose. If a doctor determines that treatment is needed, surgery may be done to remove the cyst.
Bronchogenic cysts form during fetal development. They consist of small pockets lined with respiratory epithelium, which is characterized by the presence of small hair-like structures called cilia. Sometimes the cyst will be filled with air or liquid, and some have mucous glands. Cysts can be found around the windpipe, lungs, and upper sternum area. The walls of the cyst are usually thin and the structure can vary in size.
In infants and young children, a bronchogenic cyst sometimes puts pressure on vital organs and can be potentially dangerous because the patient may have difficulty breathing or have other medical problems. In adults, bronchogenic cysts sometimes rupture, leading to infection, and have also been linked to some cases of obstructive pneumonia. For most people, however, a bronchogenic cyst poses no threat and may never be detected.
Detection of bronchogenic cysts is rare, but it should not be assumed that the cysts themselves are rare. Determining incidence rates is very difficult because they are rarely diagnosed. Medical imaging studies of the chest are needed to diagnose a bronchogenic cyst, and sometimes the unusual growth is hard to see, especially if a radiologist hasn’t seen many of them during their career. When patients have symptoms that could be indicative of a bronchogenic cyst, a doctor may request a medical imaging study to check. Sometimes prenatal ultrasound also reveals these structures.
If a doctor identifies a bronchogenic cyst, options can be discussed with the patient. Surgery may be recommended because there are concerns about the risk of rupture or infection, and it may be advisable to simply remove the cyst so these risks are not a problem. However, if a patient is not a good candidate for surgery, the doctor may recommend a wait-and-see approach to see if the cyst can be managed without surgery. Patients may also find it helpful to get a second opinion from another doctor.
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