The Bronchogenic cyst: a diagnostic challenge as cervical swelling

Abstract

Introduction: Bronchogenic cyst is a developmental anomaly of primitive foregut, usually diagnosed at birth or soon after. Commonly seen as intrapulmonary and mediastinal pathology, it is also reported at other sites, including neck, as a subcutaneous swelling. It seldom produces symptom unless it keeps growing due to persistent secretion and produces compressive symptoms. Abscess formation, discharging sinus or malignant transformation may occur rarely.

Case report: A 26 years old male presented with a midline suprasternal swelling. Clinical examination revealed a 6x4cm size soft, mobile, nontender, cystic swelling which did not move upward on deglutition or on protrusion of tongue. Radiological evaluation of neck confirmed a cystic lesion in subcutaneous plane. Differential diagnosis of Thyroglossal cyst, dermoid cyst, branchial cyst, bronchogenic cyst, and Trichilemmal cyst were considered. Histological examination following excision confirmed the diagnosis of Bronchogenic cyst.

Discussion: Surgery is the treatment of choice in cases of cervical cystic swellings which merit a wide range of differential diagnosis. Diagnosis of Bronchogenic cyst is confirmed by typical respiratory epithelial lining with interspersed goblet cells and smooth muscle fibres in the cyst lining.