M E Ribet1, M C Copin, B H Gosselin. 1. Service de Chirurgie and Laboratoire d'Anatomie Pathologique, Hôpital Calmette, Centre Hospitalier Régional Universitaire, Lille, France.
Abstract
BACKGROUND: The clinical presentation of lung bronchogenic cysts (BC) is variable, from respiratory distress at birth to late appearance of symptoms. METHODS: This study of BC was based on a retrospective review of 41 cases: 21 infants and children and 20 adults, aged 1 day to 68 years. The diagnosis was antenatal in 4 cases. Three infants required mechanical ventilation, and 2 had their cyst drained before resection. Twenty infants and children and 17 adults underwent operations. RESULTS: Compression was the most important complication in infants and children. Cough, infection, and hemoptysis occurred later in life; 80% of the total population was symptomatic. Seven cysts were infected. There were no deaths after resection, and there was no recurrence of symptoms during the follow-up period (13 months to 21 years). CONCLUSIONS: Bronchogenic cysts originate from the foregut. Differentiation from other acquired or congenital lesions can be difficult. It is uncertain what proportion of BC remain asymptomatic. More than half of patients are diagnosed after the age of 15 years, and complications may appear late. Clinical findings and plain chest radiograms are often sufficient for diagnosis. Lobectomy is the standard treatment, whereas drainage is a temporary, palliative, and risky procedure in cases of life-threatening compression. We conclude that a symptomatic BC is an indication for resection and that the long-term prognosis of an asymptomatic BC is unpredictable. Thus, there is a role for preventive operations.
BACKGROUND: The clinical presentation of lung bronchogenic cysts (BC) is variable, from respiratory distress at birth to late appearance of symptoms. METHODS: This study of BC was based on a retrospective review of 41 cases: 21 infants and children and 20 adults, aged 1 day to 68 years. The diagnosis was antenatal in 4 cases. Three infants required mechanical ventilation, and 2 had their cyst drained before resection. Twenty infants and children and 17 adults underwent operations. RESULTS: Compression was the most important complication in infants and children. Cough, infection, and hemoptysis occurred later in life; 80% of the total population was symptomatic. Seven cysts were infected. There were no deaths after resection, and there was no recurrence of symptoms during the follow-up period (13 months to 21 years). CONCLUSIONS: Bronchogenic cysts originate from the foregut. Differentiation from other acquired or congenital lesions can be difficult. It is uncertain what proportion of BC remain asymptomatic. More than half of patients are diagnosed after the age of 15 years, and complications may appear late. Clinical findings and plain chest radiograms are often sufficient for diagnosis. Lobectomy is the standard treatment, whereas drainage is a temporary, palliative, and risky procedure in cases of life-threatening compression. We conclude that a symptomatic BC is an indication for resection and that the long-term prognosis of an asymptomatic BC is unpredictable. Thus, there is a role for preventive operations.
Authors: Cornelis G Vos; Koen J Hartemink; Richard P Golding; J Wolter A Oosterhuis; Marinus A Paul Journal: Wien Klin Wochenschr Date: 2011-02-28 Impact factor: 1.704