Malek est un jeune garçon âgé de 3 ans. A l'occasion d'un épisode de bronchite aigue, il a eu une radiographie du thorax qui a permis de découvrir fortuitement une opacité médiastinale. L'IRM est en faveur d'un kyste bronchogénique.
Malek a été opéré, il a eu une résection du kyste.
Explications:
1/ Les kystes bronchogéniques sont des tumeurs sphériques ou ovoïdes de taille variable : 1 cm à 20 cm.
2/ Ils peuvent être uniques ou multiples de siège médiastinal ou parenchymateux.
3/ Ils sont soit¨découverts fortuitement, soit à la suite d'une¨détresse respiratoire néonatale, soit à l'occasion de signes de compression: trachéale ou bronchique (dyspnée, stridor, « wheezing », toux rebelle, accès de cyanose, douleurs thoraciques,dysphagie, paralysie récurrentielle..)
4/ Au cours de leur évolution, ils peuvent: s'infecter, se rompre ou même dégénérer.
5/ leur traitement repose sur l'exérèse.
Pour plus de renseignements:
http://sumerdoc.blogspot.com/2010/12/bronchogenic-cyst-mri.html
Pour plus de renseignements:
http://sumerdoc.blogspot.com/2010/12/bronchogenic-cyst-mri.html
Bronchogenic Cyst-MRI
Middle aged lady with non specific respiratory symptoms for evaluation on Xray showing opacity. CT suggested cyst. MR shows a well defined, regular, approximately 6 cm sized predominantly fluid signal intensity, thin walled space occupying lesion seen in the left anterior mediastinum with mass effect on the ipsilateral lung parenchyma, and great vessels particularly the arch of the aorta and pulmonary trunk. There is no fluid / fluid level. Features are suggestive of Bronchogenic cyst.
Case by Dr MGK Murthy
Teaching points :
- Congenital in nature derived predominantly from foregut diverticulum.
- Constitutes 40-50% of all mediastinal cyst.
- Seen as asymptomatic or nonspecific mass effect symptoms in the form of vascular or lung compression, with increase incidence in males predominantly.
- Usually fluid signal on all studies with possible T1 hyperintensity suggesting proteinaceous contents with no water lilly sign or nodules or septae or fluid blood levels or calcification.
- Differential diagnosis includes parasitic ( water lily sign would help for hydatid), teratoma ( fat or calcification ), thymic, ( nonhomogenous, presence of thymomegaly ), ectopic thyroid, ( intense uptake of iodine based contrast agents with heterogenity), great vessels aneurysms, ( presence of flow signal abnormality, calcification ), and nonspecific etiology.
- CEMR would usually help exclude enhancing nodule within, which could suggest malignant transformation, as squamous metaplasia is a known sequale.
Case by Dr MGK Murthy
- Congenital in nature derived predominantly from foregut diverticulum.
- Constitutes 40-50% of all mediastinal cyst.
- Seen as asymptomatic or nonspecific mass effect symptoms in the form of vascular or lung compression, with increase incidence in males predominantly.
- Usually fluid signal on all studies with possible T1 hyperintensity suggesting proteinaceous contents with no water lilly sign or nodules or septae or fluid blood levels or calcification.
- Differential diagnosis includes parasitic ( water lily sign would help for hydatid), teratoma ( fat or calcification ), thymic, ( nonhomogenous, presence of thymomegaly ), ectopic thyroid, ( intense uptake of iodine based contrast agents with heterogenity), great vessels aneurysms, ( presence of flow signal abnormality, calcification ), and nonspecific etiology.
- CEMR would usually help exclude enhancing nodule within, which could suggest malignant transformation, as squamous metaplasia is a known sequale.
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