Zambudio Antonio Ríos, Lanzas Juan Torres, Calvo María José Roca, Fernández Pedro J Galindo, Paricio Pascual Parrilla
Department of Surgery, Virgen de la Arrixaca University Hospital, 30120 El Palmar, Murcia, Spain.
Eur J Cardiothorac Surg. 2002 Nov;22(5):712-6. doi: 10.1016/s1010-7940(02)00484-0.
The non-neoplastic mediastinal cysts (NNMCs) form a group of uncommon benign lesions of a congenital origin. The significant controversy regarding these cysts is whether to manage with observation or surgical resection. The aim of this study is to analyse the utility of thoracic computed axial tomography (CT) in imaging diagnosis of the NNMCs and the results of surgery in these lesions.
Twenty NNMCs underwent surgery between 1980 and 2000. The preoperative study of mediastinal cystic masses includes a complete blood test, chest radiography (CR) and, for the last 15 years, a thoracic CT and/or nuclear magnetic resonance. All the patients underwent surgery in our thoracic surgery department and were reviewed in outpatients at 1 month, 6 months, 1 year and biannually thereafter. The form of manifestation, clinical features, imaging techniques, surgical operation, morbidity, mortality and follow-up are analysed.
Ten corresponded to bronchogenic cysts, the most common symptom of which was chest pain. CR showed a mass in the anterior-superior mediastinum in nine cases, and CT (five cases) revealed a cystic tumour in the anterior mediastinum. All were removed surgically, with three patients presenting with mild complications. Seven corresponded to pleuro-pericardial cysts, four being asymptomatic. CR showed a right paracardial mediastinal tumour, which was confirmed by CT (four cases). All were removed surgically, with two patients presenting with mild complications. Three corresponded to enteric cysts. CR showed a tumour in the posterior mediastinum, with CT confirming its cystic nature (two cases). Excision of the cyst was done in all cases, which corresponded to duplication cysts: two oesophageal and one gastric. All the patients are asymptomatic and recurrence-free after a follow-up of 11 +/- 10 years.
NNMCs are benign lesions in which the lesions in which the surgery can be done with a low morbidity and mortality rate, enables us to rule out malignancy and offers a definitive cure. Actually the thoracic CT permit a correct diagnosis pre-surgery in function of the radiologic characterisation and topography.
非肿瘤性纵隔囊肿（NNMCs）是一组先天性起源的罕见良性病变。关于这些囊肿的重大争议在于采用观察还是手术切除的方式进行处理。本研究的目的是分析胸部计算机断层扫描（CT）在NNMCs影像诊断中的作用以及这些病变的手术结果。
1980年至2000年间，20例NNMCs患者接受了手术。纵隔囊性肿块的术前检查包括全血细胞计数、胸部X线摄影（CR），在过去15年中还包括胸部CT和/或核磁共振检查。所有患者均在我院胸外科接受手术，并在术后1个月、6个月、1年进行门诊复查，此后每半年复查一次。分析其表现形式、临床特征、影像技术、手术操作、发病率、死亡率及随访情况。
10例为支气管源性囊肿，最常见症状为胸痛。CR显示9例在前上纵隔有肿块，CT（5例）显示前纵隔有囊性肿瘤。所有病例均行手术切除，3例患者出现轻度并发症。7例为胸膜心包囊肿，4例无症状。CR显示右心旁纵隔肿瘤，CT（4例）证实了这一结果。所有病例均行手术切除，2例患者出现轻度并发症。3例为肠源性囊肿。CR显示后纵隔有肿瘤，CT（2例）证实其囊性性质。所有病例均行囊肿切除术，这些囊肿均为重复囊肿：2例食管重复囊肿和1例胃重复囊肿。所有患者在随访11±10年后均无症状且无复发。
NNMCs是良性病变，手术可在低发病率和死亡率的情况下进行，能够排除恶性肿瘤并实现根治。实际上，胸部CT根据影像学特征和部位可在术前做出正确诊断。
