Diseases & Conditions
Boston Medical Center's Division of Thoracic Surgery treats a broad range of conditions, including bronchogenic cysts. We combine medical excellence, technologically advanced facilities and equipment and a patient-centered approach to provide fast, accurate diagnoses and effective treatments.
What are Bronchogenic Cysts?
Bronchogenic cysts are abnormal growths of tissue that are congenital (present from birth). They typically have thin walls and are filled with fluid or mucous. Most bronchogenic cysts are found in the mediastinum, the part of the chest cavity that separates the lungs.
The heart, aorta (the body's largest artery), esophagus, thymus (a gland), trachea, lymph nodes and nerves are contained in the mediastinum, which is bordered by the breastbone (or sternum) in front, the spine in back and the lungs on either side.
Because bronchogenic cysts can grow in different areas of the mediastinum, physicians often divide the mediastinum into three sections: anterior, or front; middle; and posterior, or back. Bronchogenic cysts can develop in any section of the mediastinum, but most develop in the middle.
Many bronchogenic cysts produce no symptoms and are diagnosed during a test for another reason. Symptoms can develop if the cyst grows large enough to press on parts of the airway, or the esophagus, or if the cyst becomes infected. Symptoms of bronchogenic cysts include fever from infection, vague respiratory problems and trouble swallowing.
Bronchogenic cysts are congenital (present from birth), and their cause is unknown.
Thoracic surgeons at BMC will work with you and your primary care physician to diagnose bronchogenic cysts. Tests your doctor might recommend to diagnose bronchogenic cysts include:
- X-rays, which provide an image of the heart, lungs, airways, blood vessels and bones in the spine and chest area.
- Esophagrams, which are a series of X-rays of your esophagus. You will be asked to drink a barium sulfate liquid while X-rays are taken of the swallowing process. As the liquid moves from the mouth down to the esophagus, your doctor can assess any narrowing, enlargement or abnormalities. You will most likely be asked not to eat or drink for 8 to 10 hours before the test.
- Computed tomography (CT) scans, which use X-rays to create two-dimensional images of the body, including lymph nodes. If contrast dye is used to improve the computer image, you may need to avoid eating or drinking for four to six hours before the test. Be sure to tell your doctor before the test if you have any allergies or if you have kidney problems.
- Magnetic resonance imaging (MRI), which is a painless, radiation-free test that uses a magnetic field, radiofrequency pulses and a computer to produce detailed images of body structures in multiple places. You may be asked to drink a contrast solution for better imaging, and you will most likely lie on a moving table as pictures are taken. MRI is a more detailed tool than X-ray and ultrasound and for certain organs or areas of the body it provides better images than CT.
Your physician might also recommend a bronchoscopy, in which he or she passes a small, hollow tube (or bronchoscope) through your nose and throat into the main airway of the lungs after you receive a sedative. This procedure allows physicians to see any abnormalities that might be present.
After a careful evaluation of your condition, we will recommend the treatment that is most appropriate for you. The goal of bronchogenic cyst treatment is to remove the cyst, which is called resection. There are several types of mediastinal tumor resection for cysts, including:
- Thoracotomy, in which the surgeon makes an incision on the side, the back, or in some cases, between the ribs to gain access to the chest cavity. The surgeon then locates and removes the cyst.
- Video-assisted thorascopic surgery (VATS), a minimally invasive alternative to open chest surgery that involves less pain and recovery time. After giving you general anesthesia, the physician makes small incisions in your chest and then inserts a fiber-optic camera, called a thorascope, as well as surgical instruments. As the physician moves the thorascope around, images that provide important information are transmitted to a video monitor. The surgeon can then locate and remove the cyst.
- Robotic resection, in which the surgeon guides robotic instruments to perform the procedure. The surgeon’s hand movements guide the instruments by means of a control console and a computer.