Bronchogenic cyst: Imaging features with clinical and histopathologic correlation

PURPOSE: To characterize the imaging features of bronchogenic cysts. MATERIALS AND METHODS: The computed tomographic(CT) and/or magnetic resonan ce (MR) or ultrasonographic images in 68 histopathologically proved cases o f bronchogenic cyst in 38 male and 30 female patients, aged newborn to 72 y ears (mean, 22 years), were retrospectively reviewed. RESULTS: There were 58 mediastinal and 10 extramediastinal cysts. At CT (n = 62), 60 cysts were sharply marginated with smooth (n = 35) or lobulated ( n = 25) borders. Twenty-five cysts were of water attenuation, 25 were of so ft-tissue attenuation, two were air filled, two had an air-fluid level, and two had:dependent milk of calcium. On T1-weighted MR images (n = 23), 18 c ysts were hyperintense land five were isointense to cerebrospinal fluid. On T2-weighted MR images (n = 18), 17 cysts were isointense or hyperintense t o cerebrospinal fluid. Of the 25 soft-tissue-attenuation lesions at CT, 11 appeared cystic because of internal homogeneity, tack of internal enhanceme nt, mural enhancement, and characteristic location. Fourteen appeared solid based on morphology and attenuation. MR imaging of nine of the latter show ed marked hyperintensity on T2-weighted images. CONCLUSION: CT of bronchogenic cysts typically shows sharply marginated med iastinal masses of soft-tissue or water attenuation.:Most appear cystic. A minority appear solid and can be confused with other lesions; MR imaging:ca n be Useful for elucidating the cystic nature of these lesions.