Ohbayashi T, Sudo K, Unno T, Hamada Y, Morita H, Hayashi N, Tadokoro M, Noguchi K, Ikeda K, Mizuno A
Department of Thoracic and Cardiovascular Surgery, Kyorin University School of Medicine.
Kyobu Geka. 1990 Jun;43(6):487-90.
A 42-year-old house wife had suffered from abnormal mass lesion in the right pulmonary hilum on her chest X-ray film. MRI showed another mediastinal mass between IVC and descending aorta with high T1 and T2 intensity. Thoracic CT done before MRI missed the latter lesion because only upper mediastinal scanning had been performed. At operation subcarinal and right paraesophageal cysts were successfully removed. Histological examination of the subcarinal cyst showed ciliated pseudostratified columnar epithelium lining, and its thin wall consisted of partly smooth muscle bundle, lymph node, calcification, inflammatory cell infiltration and hemorrhage. The paraesophageal cyst lined by a ciliated pseudostratified columnar epithelium, and the wall consisted of mostly fibrous connective tissue with partly smooth muscle bundle. Although the both cysts were diagnosed as bronchogenic origin, definitive bronchial glands and cartilage could not be recognized. The postoperative course was uneventful. This is the first case report of mediastinal double bronchogenic cysts appeared in the Japanese literature.
一名42岁的家庭主妇胸部X光片显示右肺门有异常肿块。磁共振成像（MRI）显示下腔静脉和降主动脉之间有另一个纵隔肿块，T1和T2信号强度高。MRI检查前进行的胸部CT因仅进行了上纵隔扫描而漏诊了后一个病变。手术中成功切除了隆突下和右食管旁囊肿。隆突下囊肿的组织学检查显示内衬纤毛假复层柱状上皮，其薄壁部分由平滑肌束、淋巴结、钙化、炎性细胞浸润和出血组成。食管旁囊肿内衬纤毛假复层柱状上皮，壁主要由纤维结缔组织组成，部分有平滑肌束。尽管两个囊肿均诊断为支气管源性，但未发现明确的支气管腺体和软骨。术后过程顺利。这是日本文献中首例纵隔双支气管源性囊肿的病例报告。
