Bronchogenic cyst differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Joanna Ekabua, M.D. [2]
Overview
Bronchogenic cyst must be differentiated from lung abcess, thymic cyst, and esophageal duplication cysts
Differentiating Bronchogenic cyst from other Diseases
Differentiating bronchogenic cyst from lung abcess, thymic cyst, and esophageal duplication cysts
| Diseases | Clinical manifestations | Para-clinical findings | Gold standard | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Symptoms | Physical examination | |||||||||||||
| Lab Findings | Imaging | Histopathology | ||||||||||||
| Symptom 1 | Symptom 2 | Symptom 3 | Physical exam 1 | Physical exam 2 | Physical exam 3 | Lab 1 | Lab 2 | Lab 3 | Imaging 1 | Imaging 2 | Imaging 3 | |||
| Lung abcess[1] | Fever | Chest pain | night sweats | Dullness to percussion | coarse inspiratory crackles | Decreased breath sounds | Leukocytosis | Increased inflamatory markers (ESR, CRP) | Anemia of chronic disease |  Frontal view of CXR showing lung abscess with air-fluid level. Case courtesy of Dr Abu-Rahmeh Zuhair (Picture courtesy: Radiopaedia) |
 Lateral view 0f CXR showing lung abscess with air-fluid level. Case courtesy of Dr Abu-Rahmeh Zuhair (Picture courtesy: Radiopaedia) |
 Non-contrast CT showing lung abscess with air-fluid levels. Case courtesy of Dr Elsayed Mohamed Elsayed (Picture courtesy: Radiopaedia) |
CT with intravenous contrast | |
| Thymic cyst[2] | Cough | Chest pain | Dyspnea | Some patients may present with a soft compressible neck mass | - | - | - | - | - |  x-ray scan showing a thymic mass (yellow arrowhead). Case courtesy of Dr. Stefan Ludwig (Picture courtesy: Radiopaedia) |
 CT scan showing a thymic mass corresponds to a cystic lesion (yellowarrow head). Case courtesy of Dr. Stefan Ludwig (Picture courtesy: Radiopaedia) |
 CT scan showing a calcified thymic mass corresponds to a cystic lesion (yellow arrowhead). Case courtesy of Dr Bruno Di Muzio (Picture courtesy: Radiopaedia) |
 H&E stain of thymic cyst showing bland squamous epithelium and some thymic tissue in its wall. Case courtesy of Dr Hanni Gulwani (Picture courtesy: Pathologyoutlines) |
Biopsy withhistopathology and cytology |
| Esophageal duplication cysts[2][3][2] | Retrosternal and thoracic back pain | Epigastric discomfort | Dysphagia | - | - | - | - | - | - |  |
 X-ray post barium swallow showing an oval mass compressing the esophagus. Case courtesy of Dr Michael P Hartung (Picture courtesy: Radiopaedia) |
 CT showing an esophageal duplication cyst. Case courtesy of Assoc Prof Craig Hacking (Picture courtesy: Radiopaedia) |
 Histologic image of an esophageal duplication cyst showing two-layered muscle coat like the GIT, and epithelium lining of pseudo-ciliated columnar cells. (Picture courtesy: National Center for Biotechnology Information) |
Endoscopic ultrasound
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References
- ↑ Kuhajda I, Zarogoulidis K, Tsirgogianni K, Tsavlis D, Kioumis I, Kosmidis C; et al. (2015). "Lung abscess-etiology, diagnostic and treatment options". Ann Transl Med. 3 (13): 183. doi:10.3978/j.issn.2305-5839.2015.07.08. PMC 4543327. PMID 26366400.
- ↑ 2.0 2.1 2.2 Juanpere S, Cañete N, Ortuño P, Martínez S, Sanchez G, Bernado L (2013). "A diagnostic approach to the mediastinal masses". Insights Imaging. 4 (1): 29–52. doi:10.1007/s13244-012-0201-0. PMC 3579993. PMID 23225215.
- ↑ Liu R, Adler DG (2014). "Duplication cysts: Diagnosis, management, and the role of endoscopic ultrasound". Endosc Ultrasound. 3 (3): 152–60. doi:10.4103/2303-9027.138783. PMC 4145475. PMID 25184121.