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.