1/16. Intrapericardial bronchogenic cysts.A rare case of large intrapericardial bronchogenic cyst with superior vena caval obstruction is reported. The cyst was successfully removed and the superior vena cava, which was narrowed by pressure fibrosis and thrombosis, was reconstructed satisfactorily and has maintained patency. In another case a large cyst of the same type without vena caval obstruction was successfully treated surgically. The features of these 2 cases are compared with those of 20 reported cases. The angiographic data in these cases appear to be sufficiently characteristic to suggest the nature of the lesion and the clinical finding of pericarditis early in the course of the disease may also suggest the diagnosis.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/16. Cystic thymoma simulating contrictive pericarditis. The role of echocardiography in the differential diagnosis.A case is presented of a 60-year-old woman with fatigue, dyspnea, and chest pain. A chest x-ray film revealed an abnormal cardiac silhouette. echocardiography revealed a large, echo-free area with well-demarcated, discrete borders adjacent to the right heart border. This structure decreased in size with inspiration and did not show pulsatile cardiac motion. cardiac catheterization confirmed the extracardiac nature of the lesion and also showed a "constrictive" pattern with equalization of diastolic pressures. Surgical exploration revealed a large cystic thymoma. With removal of the tumor, intracardiac pressures returned to normal.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/16. A case of asymptomatic cardiopericardial hydatid cyst.Cases with cardiac hydatid cyst disease are uncommon, being approximately 0.2-2% of all cases. Most cardiac hydatid cysts are located in the interventricular septum or left ventricular wall. Pericardial location is very rare. We report a 42-year old Turkish man with pericardial hydatid cyst disease who was otherwise asymptomatic, having no cardiac symptomatology. The most appropriate therapeutical option for a hydatid cyst is surgical removal of the cyst mass. However, our patient refused surgical treatment and thus medical treatment with albendazole was initiated. Following the first month of the drug therapy, pericardial effusion disappeared. The cystic nature of the mass disappeared and was solidified at the 6th month of treatment. The patient has been followed-up by us asymptomatically.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/16. mediastinoscopy in the treatment of mediastinal cysts.OBJECTIVE: Primary cysts constitute 25% of all masses in the mediastinum. Because radiological investigations are often inconclusive, many adults require mediastinoscopy, thoracotomy, video-assisted thoracic surgery, or computed tomography-guided transbronchial, transesophageal, or transcutaneous aspiration to confirm the cystic nature of these lesions. Minimally invasive procedures fail when the cyst contents are gelatinous and mucoid (failure to aspirate) or when the cyst wall continues to secrete fluid. Though Pursel reported mediastinoscopic extirpation of benign cysts 35 years ago, it remains a "therapeutic curiosity" with sporadic reports of its usage. We report 2 successful mediastinal cyst extirpations performed as outpatient procedures and review the literature with regards to its management. methods: A rigid, 8-mm mediastinoscope was inserted into the anterior mediastinum following the creation of a 2-cm suprasternal incision and dissection along the anterior surface of the trachea. After aspiration, cytology of the contents revealed their benign nature. Right paratracheal cysts in 2 adult males were successfully removed mediastinoscopically by blunt and sharp dissection. RESULTS: Histopathology revealed benign mesothelial cysts in both instances. Both patients had an uncomplicated procedure and were discharged within 23 hours. No other pathology was detected on mediastinoscopy, and follow-up at 3 months and 6 months has revealed no recurrence. CONCLUSION: Mediastinoscopic cyst removal is a minimally invasive procedure with a very low morbidity and mortality rate. morbidity, recovery, and discharge times are much less than those of more invasive procedures (video-assisted thoracic surgery / thoracotomy). We suggest that it should be the first-choice procedure for the excision of appropriately located benign mediastinal cysts.- - - - - - - - - - ranking = 2keywords = nature (Clic here for more details about this article) |
5/16. Acutely symptomatic benign mediastinal cysts.Usually, cystic mediastinal masses are considered as benign. However, the size of the cyst is of importance, chiefly in a closed space such as the superior mediastinum. Rarely a dramatic symptomatology may develop though this was the case in the two patients we describe, who were admitted in the department. In the first case (a parathyroid cyst), the symptoms were due to a thrombosis of the left innominate vein, and in the second case (a thyroid cyst), the severity was dominated by a dramatic compression of the trachea and the vessels. The contribution of computed tomography is nowadays undisputed. It enables the diagnosis of the cystic nature before surgery. The diagnosis can easily be confirmed by percutaneous drainage.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/16. Gross mural cartilage in a congenital bronchogenic cyst: MRI features.An infant who had a cardiac murmur after the delivery was evaluated with echocardiogram. A 1 cm cystic area was incidentally identified in the upper right mediastinum, that was not related with the heart. A 4 x 4.5 x 8 cm cystic mass in the superior mediastinum and lower neck was demonstrated on the magnetic resonance imaging (MRI). At surgery, a small solid structure corresponding to the nodule seen on MRI was identified, which was firm and cartilaginous in nature and attached to the wall of the cyst. Grossly visible cartilage in association with a bronchogenic cyst has not been previously reported. In conclusion, the bronchogenic cysts can have grossly visible cartilage in their wall and extend to extrathoracic spaces in a contiguous fashion, mimicking other entities such as teratomas and cystic lymphangiomas.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/16. Management of a large mediastinal cyst of thyroid origin.Large mediastinal cysts of the thyroid are rare and it is difficult to make a definitive tissue diagnosis prior to surgical removal. ultrasonography and computed axial tomography are useful in documenting the cystic nature of the lesion and demonstrating its relationship to other mediastinal structures. These studies may also suggest the tissue of origin. We report a case of massive mediastinal thyroid cyst situated in the right posterior mediastinum and causing significant tracheal compression. Because of this unusual location and lack of iodine uptake, preoperative diagnosis was not possible. At surgery, which we performed via right thoracotomy because of the location of the mass, its origin from thyroid tissue was demonstrated. Resection was accomplished with care taken not to injure the recurrent laryngeal nerve. The patient recovered uneventfully.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/16. The value of transoesophageal ultrasonography in the management of a mediastinal foregut cyst.Mediastinal foregut cysts account for approximately 10% of primary mediastinal masses. The differentiation of these cysts from other mediastinal masses is important, especially if a policy of aspiration and observation of cysts is adopted. Computed tomography (CT) is generally regarded as the definitive imaging modality in these cases, but it may occasionally fail to identify the cystic nature of the mass. We report a case in which transoesophageal ultrasound contributed to the diagnosis and demonstrated features of the cyst contents that were not visible on CT.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/16. Benign mediastinal cysts: pointed appearance on CT.A case of bronchogenic cyst and two cases of pericardial cysts are presented. Our report illustrates the diagnostic utility of a pointed contour and the dependence of contour on position on CT in establishing the cystic nature of mediastinal mass.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/16. Mediastinal pancreatic pseudocyst.We have described a case of extension into the mediastinum by a pancreatic pseudocyst. This rare phenomenon should be included in the differential diagnosis of mediastinal mass lesions. We advocate the use of CT in evaluating a mediastinal mass to determine its solid or cystic nature, size, extent, and relationship to adjacent structures.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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