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Bronchogenic Cyst

Congenital developmental anomaly arising from abnormal budding of the foregut, presenting as a thin-walled mucus-filled cyst lined by ciliated respiratory epithelium, typically located in mediastinum (subcarinal) or lung parenchyma.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

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This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Göğüs Hastalıkları department. Book Appointment →

What is Bronchogenic Cyst?

Bronchogenic cyst is a congenital foregut duplication anomaly resulting from abnormal budding of the primitive ventral foregut between weeks 4 and 6 of gestation. The cyst wall contains ciliated pseudostratified columnar (respiratory) epithelium, with smooth muscle, mucous glands, and cartilage in the wall — features that distinguish it from other foregut duplications (esophageal duplication, neurenteric cyst). Cysts are typically thin-walled and contain serous, mucous, or hemorrhagic fluid.

Anatomic distribution: mediastinal (75%, most often subcarinal followed by right paratracheal, hilar, and paraesophageal locations) and intrapulmonary parenchymal (15–25%, more frequently in lower lobes). Less commonly cervical, intraspinal, or subdiaphragmatic. Many cysts are asymptomatic and discovered incidentally on imaging. Symptomatic mediastinal cysts present with chest pain, dyspnea (compression of trachea or bronchus), dysphagia (esophageal compression), and recurrent stridor in infants. Intraparenchymal cysts often communicate with bronchi and present with productive cough, recurrent pneumonia, hemoptysis, or pneumothorax.

CT shows well-circumscribed homogeneous low-attenuation (water density) cyst, but high-protein content can mimic soft tissue. MRI characterizes content (T2 hyperintense, variable T1) and excludes vascular structures. Treatment is surgical excision (video-assisted thoracoscopic surgery, robotic, or thoracotomy) for symptomatic cysts, complications (infection, rupture, malignant transformation, compression), or to confirm diagnosis. Asymptomatic adult cysts may be observed but malignant transformation (rare, <1%) and complications favor elective resection in fit patients.

Symptoms

Asymptomatic incidental finding (common in adults)
Cough, dyspnea, wheeze (compression or infection)
Recurrent pneumonia in same lobe
Hemoptysis or chest pain
Dysphagia from esophageal compression
Stridor or respiratory distress in infants (mediastinal compression)
Pneumothorax with intrapulmonary cyst rupture

Risk Factors

Congenital — abnormal foregut budding at 4–6 weeks gestation
Sporadic occurrence (no specific genetic risk identified)
Family history rare (mostly isolated cases)
Associated with other foregut duplications
Esophageal duplication or neurenteric cyst
VACTERL association occasionally
Pulmonary sequestration (rare association)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Mediastinal or lung mass on imaging
  • Recurrent respiratory infections in same lobe
  • Persistent cough, hemoptysis, or chest pain
  • Stridor or respiratory distress in infant
  • Dysphagia or chest pressure
  • Pneumothorax with cystic lung lesion
  • Antenatal diagnosis of mediastinal cyst — pediatric surgery referral

Treatment Methods

01
Surgical excision (VATS, robotic, or thoracotomy) for symptomatic cysts
02
Cyst excision for complications (infection, rupture, malignant transformation)
03
Observation for small asymptomatic adult cysts (controversial)
04
Antibiotics for infected cysts before definitive surgery
05
Bronchoscopy and esophagoscopy to assess airway/esophageal involvement
06
Pediatric thoracic surgery for symptomatic infants
07
Histopathologic examination to confirm and exclude malignant transformation

Which Department to Visit?

You can visit our Göğüs Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Göğüs Hastalıkları Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.