Mediastinal cysts: diagnosis by CT and needle aspiration.

Five patients with bronchogenic or enteric cysts were diagnosed by using a combination of CT and transbronchial or transesophageal needle aspiration. Serous or mucoid fluid was successfully aspirated in each case. Cultures of the fluid were negative for pathogens, and cytologic examinations showed no malignancy. Mediastinoscopy and thoracotomy were avoided in all patients, including one symptomatic patient whose symptoms resolved after needle aspiration. CT with transbronchial or transesophageal needle aspiration represents a practical alternative to surgery in the evaluation of congenital mediastinal cysts.