Bagwell C E, Schiffman R J
Department of Surgery, University of Florida College of Medicine, Gainesville.
J Pediatr Surg. 1988 Nov;23(11):993-5. doi: 10.1016/s0022-3468(88)80002-2.
Recent experience with a bronchogenic cyst occurring in a subcutaneous suprasternal location presents an additional entity to be considered in the differential diagnosis of head and neck lesions, and correlates with the embryology of the developing tracheobronchial tree and sternum. A review of subcutaneous bronchogenic cysts shows 41 cases have been described in the English literature. Most were noted in the suprasternal location; all but one were first noted in infancy or childhood. There is a definite male predominance. Sinus tracts were present in four cases, but none extended into the chest or mediastinum. Although local excision led to cure in all cases, incomplete excision in two cases required reoperation. Embryologic maldevelopment is suggested as the etiology for subcutaneous bronchogenic cysts, with a "pinching off" of pulmonary parenchyma by closure of the developing lateral sternal bars, fusion of which results in an isolated bronchogenic cyst in the subcutaneous tissues of the anterior chest wall. Awareness of this lesion by pediatric surgeons in the differential diagnosis of masses or sinuses presenting in the suprasternal region may prevent incomplete excision of components, which can extend deep into the site of origin. The possibility of extension into the mediastinum should be entertained.
近期有1例发生于胸骨上皮下部位的支气管囊肿的病例，这为头颈部病变的鉴别诊断增添了一个需要考虑的新情况，并且与发育中的气管支气管树和胸骨的胚胎学相关。对皮下支气管囊肿的回顾显示，英文文献中已描述了41例。大多数位于胸骨上部位；除1例之外，所有病例均在婴儿期或儿童期首次被发现。男性明显居多。4例存在窦道，但均未延伸至胸部或纵隔。尽管所有病例经局部切除均治愈，但2例切除不完全的病例需要再次手术。胚胎发育异常被认为是皮下支气管囊肿的病因，发育中的胸骨侧条闭合导致肺实质“被夹断”，其融合会在前胸壁皮下组织中形成一个孤立的支气管囊肿。小儿外科医生在鉴别诊断胸骨上区域出现的肿块或窦道时，若能认识到这种病变，可能会避免不完全切除那些可能深入起源部位的成分。还应考虑到其延伸至纵隔的可能性。
