Kermarec J, Haguenauer G, Allard P, Epardeau J, Pellegrin A, Hocquel J
Ann Med Interne (Paris). 1979;130(1):23-9.
Five observations of mediastinal brochogenic cysts are used to illustrate the diagnostic and/or therapeutic difficulties encountered in cases with an ectopic topography or complications. In two cases, one of which was clearly located in the posterior mediastinum and associated with a false erosive appearance of the nearby vertebral body, it was possible to establish the degree of ectopic displacement of the bronchogenic cysts, and to comprehend the pre-operative diagnostic difficulties and nosological problems associated with these sequestrations. As far as complications are concerned, one observation was able to confirm that a sudden volume increase doesn't always correspond to a septic process, and that rapid secondary reduction in volume is not always accompanied by fistulation. Intracystic suppurations differ in appearance according to their location. In the subcarinal region they can cause a fistula, as in the case reported. In other regions, in this case the left lateral tracheal area, suppuration is enclosed, but it can be associated with suppurative lesions of the adjacent lung. The operative difficulties, partial cystectomy in one case and associated lobectomy in the other, are further evidence for the need for systematic excision of all bronchogenic cysts as soon as they are diagnosed and before complications occur.
通过对五例纵隔支气管源性囊肿的观察，来说明在异位或合并并发症的病例中所遇到的诊断和/或治疗困难。在两例病例中，其中一例明显位于后纵隔，并伴有邻近椎体的假侵蚀样表现，得以确定支气管源性囊肿的异位移位程度，理解与这些隔离症相关的术前诊断困难和疾病分类问题。就并发症而言，一例观察证实囊肿体积突然增大并不总是对应于感染过程，体积快速继发性缩小也并不总是伴有瘘管形成。囊内化脓根据其位置不同外观也不同。在隆突下区域，如所报道的病例那样可导致瘘管形成。在其他区域，在本病例中为左侧气管区域，化脓被包裹，但可伴有邻近肺的化脓性病变。手术困难，一例为部分囊肿切除术，另一例为联合肺叶切除术，进一步证明了一旦诊断出所有支气管源性囊肿，在并发症发生之前就需要进行系统切除的必要性。
