• Journal of Chest Surgery
• /
• v.43 no.1
• /
• pp.120-123
• /
• 2010

Bronchogenic cysts (BCs) are relatively common congenital anomalies in the mediastinum. Most of the patients with BC can be managed both safely and effectively by minimally invasive methods. Selected patients with a BC in a favorable location can have the cyst partially or completely excised by mediastinoscopic techniques. Herein we report on a case of a left lower paratracheal bronchogenic cyst that was completely resected by a video-assisted mediastinoscopic technique, and we discuss the technical aspects of this procedure.

• Tuberculosis and Respiratory Diseases
• /
• v.55 no.5
• /
• pp.526-530
• /
• 2003

Bronchogenic cysts are generally presented as a well defined mass that have thin and smooth wall in the intrapulmonary or mediastinal area by simple chest radiographs. We present the case of a 20-year-old man with a ill-defined left upper lobe mass, found by chest radiographs. At the preoperative examinations, chest computed tomography showed ill-defined mass with Hounsfield Number 26, and nonspecific findings were shown by the bronchoscopy and percutaneous needle aspiration. The patient was undertaken the left upper lobectomy. The surgical specimen contained a ill-defined mass, measuring $2{\times}3$ cm. On the section of the mass, a cyst containing dark brown thick materials was noted. The cyst was unilocular, and the wall showed a trabeculation. Microscopically, the cystic mass was lined with ciliated pseudostratified columnar epitheliums and surrounded by smooth muscle and cartilage.

• Journal of Chest Surgery
• /
• v.35 no.11
• /
• pp.807-811
• /
• 2002

Due to its less invasive nature and superior visual field, video-assisted thoracescopic excision of mediastinal mass is thought to be comparable to open thoracotomy. Material and Method : From January 1995 to August 2001, the medical records of 38 patients who underwent video-assisted thoracoscopic excision of mediastinal mass was retrospectively analyzed. The outcome of these patients were compared with 5 patients who converted to thoracotomy Result: Male to female ratio was 13(34.2%) : 25(65.8%), and mean age was 39.2$\pm$35.4 years. Regarding the pathology, there were 8 neurilemmomas(21.1%), 6 thymic cysts (15.8%), 5 teratomas(13.2%), 5 ganglioneuromas(13.2%), 4 bronchogenic cysts(10.5%), 3 pericardial cysts(7.9%), 3 thymomas(7.9%), and 2 lymphangiomas(5.3%). The mean operation time was 110.6$\pm$7.0 minutes, mean postoperative tube stay was 4.2$\pm$0.4 days, mean postoperative hospital stay was 5.2$\pm$0.4 days, and mean number of injection of analgesics was 1.9$\pm$0.4 times. Although the mean values for the above indices were less than those of the thoracotomy conversion cases, they were statistically insignificant. Postoperative complications of videoassisted thoracoscopic excision included chylothorax, prolonged air leakage, and unilateral phrenic nerve palsy, all of which recovered before patient discharge. There was, however, permanent unilateral ptosis in one patient. Conclusion : As video-assisted thoracoscopic excision of mediastinal mass is safe, less painful, conducive to earlier recovery and cosmetically more appealing, a more active application of this technique is recommeded.

• Journal of Chest Surgery
• /
• v.27 no.9
• /
• pp.812-814
• /
• 1994

The esophageal cyst result from a wrong cleavage of the primitive gut in the 4 weeks embryo. In embryo and after seperation of the tracheal diverticulum, the esophagus is lined with ciliated cells which are able cover a "cystic duplication". It is often difficult to distinguish between the bronchogenic and the esophageal cyst. Pathological findings showed the presence of a ciliated epithelium without cartilage which was diagnosed as an esophageal cyst. The patient was 21 year old man for evaluation of the cyst in the posterior mediastinum. The cyst was located the intramural esophagus. Microscopically, the cyst was lined with ciliated columnar epithelium and there was no evidence of cartilage. The cyst was confirmed as the intramural esophageal cyst.geal cyst.

• Tuberculosis and Respiratory Diseases
• /
• v.55 no.1
• /
• pp.107-112
• /
• 2003

A congenital cystic adenoid malformation of the lung(CCAM) is characterized by an anomalous fetal development of the terminal respiratory structures, resulting in the adenomatoid proliferation of the bronchiolar elements and cystic formation. CCAM has been detected on the fetus, premature babies and stillborn as well as infants and children. An adult presentation of CCAM is extremely rare. When cystic lesions occur with a repeated infection, an evaluation of the cystic lesions requires a differential diagnosis of CCAM, sequestration, a lung abscess, a pneumatocele and a bronchogenic cyst. The definite treatment of CCAM is the surgical removal of the involved lobe. We report a case of a CCAM in a 24-year-old female with a brief review of the relevant literature.

• Journal of Chest Surgery
• /
• v.16 no.4
• /
• pp.594-601
• /
• 1983

Mediastinal tumors have long fascinated the thoracic surgeon because of their variety and unpredictability of diagnosis prior to exploration. We report the analysis of the 110 cases of mediastinal tumors, experienced in the dept. of the thoracic and cardiovascular surgery of the National Medical Center from December 1959 to August 1983. The age distribution was relatively even and the mean age was 37 years old. The germ cell tumors were 29 cases [31%], the neurogenic tumors were 19 cases [20%], the thymomas were 16 cases [17%], the lymphomas were 8 cases [8.5%], the primary or secondary carcinomas were 11 cases [12%], the bronchogenic and the P.W cysts were 4 cases, the mesenchymal tumors were 3 cases, the TB gangliomas were 3 cases among the 94 cases, histologically analysed. The malignant tumors were 39 cases [41%]. In classified by histological types, the tumor size, location and the clinical manifestations are presented. The successful removal was done in 53 cases [96%] among 55 cases of benign mediastinal tumors. In 39 malignant cases, the surgical intervention had been done in 21 cases [54%], and inoperable cases were 16 [41%], and the operative deaths were 2 cases [5%].

• Journal of Chest Surgery
• /
• v.23 no.4
• /
• pp.698-706
• /
• 1990

Congenital Cystic Lung Disease is a spectrum of closed related anomalies that arise during an early stage of embryonic lung bud maturation-namely bronchogenic cyst, congenital lobar emphysema, pulmonary sequestration and congenital cystic adenomatoid malformation. And they show similar surgical strategies. So they are called as the term bronchopulmonary-foregut malformations, firstly proposed by Gerle[1968]. From Aug. 1979 to Aug 1989, 47 patients were operated upon on Dept. of Thoracic & Cardiovascular Surgery at the CUMC. There were 21 females and 26 males ranging in age from age of 21 day to age of 56 year [15 cases under 15 years old]. 30 patients had bronchogenic cysts - 23 of intrapulmonary type, 7 of mediastinal type in location. Affected lobes and locations were as follows: 11 in upper lobe, 3 in middle lobe, 11 in lower lobe and anterosuperior, middle, and posterior mediastinal type were 3, 2, 2 respectively. There were 9 pulmonary sequestrations[all intralobar type] with the distribution of 5 in right lower lobe and 4 in left lower lobe. And associated anomalies were presented with arterial supply originating from thoracic aorta[8 cases], abdominal aorta[1 case] and with venous drainage into azygos vein[1 case]. They all were operated upon lower lobectomy [8 case], pneumonectomy[1 case] in case of pulmonary hypoplasia Congenital lobar emphysema and congenital cystic adenomatoid malformation had 4 cases respectively. Their affected lobes were as follows: the former were 3 in upper lobes, 1 in middle lobe and the latter were 3 in upper lobe, 1 in lower lobe. They were treated with lobectomy and segmentectomy. Diagnosis was aided by chest X - ray, bronchography, aortography, DSA and CT scan, They all were confirmed by pathologic exams. There were no hospital death but few minor morbidities such as, atelectasis-pneumonia[2], wound infection[2], prolonged chest tube placement[2]. We experienced surgical treatments of 47 cases for 10 years and reported them with literature review.

• Journal of Yeungnam Medical Science
• /
• v.6 no.2
• /
• pp.79-90
• /
• 1989

Computerized Tomography is now well established and important noninvasive method of diagnosting mediastinal mass lesions because of its superior imaging of their size, location and internal composition. Authors ana lysed and present CT findings of 30 surgically proven mediastinal tumors and cysts that were studied and treated at the Yeungnam University Hospital during recent 6 years. The most common tumor was thymona(9 cases), and teratoma(6 cases), lymphoma(6 cases), bronchogenic cyst(4 cases), neurogenic tumor (4 cases), pericardial cyst(1 case) were next in order of frequency. There were 5 cases of thymoma showing homogenous solid density mass, 2 cases were malignant thymoma and myasthenia gravis was present in 2 cases. A case of thymolipoma and a case of thymic carcinoma were included. All teratomas were cystic masses but pathognomic fat, and calcified density were seen only in 4 cases. 5 cases were located in anterior mediastinum and 1 case was in posterior mediastinum. Lymphoma(3 Hodgkin's and 3 non-Hodgkin's) appeared as irregular lobulated mass in anterior mediastinum. Neurogenic tumor(2 ganglioneuroma and 2 neurilemmoma) appeared as homogenous density mass located in posterior mediastinum. Among the 4 bronchogenic cysts, 2 were located in retrotracheal area, 1 was located in subcarinal and 1 was in parathoracic area. One case of pericardial cyst was oval shaped cystic mass located in left pericardiac border.

• Journal of Chest Surgery
• /
• v.27 no.3
• /
• pp.226-229
• /
• 1994

VATS is now used by many thoracic surgeons and in various anatomic locations such as lung parenchyme, pleura and mediastinum, etc. VATS of mediastinal masses has special characteristics compared to that of other diseases. Those are no positional changes of the mass during collapse of the lung and close proximity of the mass to major vascular structures, nerves and other vital organs. From 1992. July to 1993. August, 10 mediastinal masses were treated with video assisted thoracoscopy. There were five males and five females, ages ranged from 11 years to 65 years with average 37.7 17.7 years old. Of the 10 patients, 4 were bronchogenic cysts, 2 were teratoma, and the others were thymoma, neurilemmoma, pericardial cyst, and thymic cyst. Needle aspiration was done in large cysts and the working thoracotomy[or utility thoracotomy] was done in large solid masses for the purpose of easy dissection, easy handling and easy delivery of the mass. The average operation time were 155.6 6.8 minutes and the duration of air leakage were 1 2.2 days. The duration of the chest tube drainage were 3.3 2.6 days. The lengths of the postoperative hospitalization were 5.1 2.7 days which were shorter than those of 12 mediastinal masses treated with conventional thoracotomy during the same periods [p<0.05]. There was 1 patient converted to thoracotomy because of a bleeding at innominate vein. 3 postoperative complications were occured. Those were persistent air leakage for 7 days, diaphragmatic palsy and hoarseness which were recovered within 1 month. We conclude that mediastinal mass can be excised with video assisted thoracoscopy and the posthospitalization is reduced. But careful attention is required for avoiding injury to major vascular structures, nerves, and other vital organs.

• Korean Journal of Head & Neck Oncology
• /
• v.33 no.2
• /
• pp.49-53
• /
• 2017

Foregut cystic developmental malformations are rare developmental anomalies. It is important to diagnose the diseases and manage them properly because these cysts may generate feeding or respiratory difficulties depending on the size and location of the lesions. A newborn was referred for a congenital cervical swelling to our clinic on the second day of his life. Neck SONO and MRI showed an about 6cm sized cystic mass at left submandibular area. Aspirations and sclerotherapies were done repeatedly due to recurred cystic mass. Under the suspicious of cystic hygroma, the mass and submandibular gland were excised. Histologically, it was a benign cyst including gastrointestinal and bronchogenic mucosa and pancreatic tissue. Foregut cyst was suggested for the final diagnosis and the patient was discharged at 9 days after the operation without a complication. He has visited our out-patient department. Although several image studies have been introduced to find out foregut cyst, it is difficult to go through differential diagnosis because of similarity of other benign tumor. Further studies for early diagnosis of cervical foregut cyst are needed for preventing possible related problems.