An asymptomatic 49-year-old man was referred because of an abnormal chest roentgenogram. Findings from physical examination were normal. Chest roentgenograms, tomogram, and esophagogram are presented (Fig 1 through 4).
Bronchogenic cyst. An oval hemogeneous shadow to the left of the upper posterior mediastinum was found on the chest roentgenogram. Fluoroscopy and barium study showed this mass to be paraesophageal.1 It moved with swallowing. No intrinsic pulsations were seen. Differential diagnosis included enteric cyst, bronchogenic cyst, esophageal tumor (eg, leiomyoma), substernal thyroid, lymph node enlargement, and vascular lesion.2Radioactive iodine scan showed no uptake in the mass, and the thyroid gland appeared normal. Thoracic aortography was also normal.At surgery, a 5-cm diameter cyst was found loosely attached posteriorly to the esophageal wall. It contained mucoid material. Histological sections of the wall showed ciliated pseudostratified columnar epithelium and underlying hyaline cartilage.
Bronchogenic cysts are developmental in