Bronchogenic Cysts

What are bronchogenic cysts?

Bronchogenic cysts are a type of mediastinal tumor. This means they develop in the mediastinum — the part of your chest that contains the trachea, bronchi and bronchioles. Bronchogenic cysts are usually small and filled with fluid or mucous.

Who do bronchogenic cysts affect?

Bronchogenic cysts are congenital, meaning people are born with them. Symptoms can emerge at any age; though, most cases are discovered when people are in their 30s or 40s. Statistically, bronchogenic cysts affect slightly more men than women.

How common are bronchogenic cysts?

These lesions are considered rare. They only make up about 5% to 10% of mediastinal tumors affecting infants and children.

Are bronchogenic cysts cancerous?

While bronchogenic cysts aren’t usually cancerous, there is a small chance that they could become malignant (cancerous) over time. Because of this, removal is usually recommended.

What are the symptoms of bronchogenic cysts?

In many cases, people with bronchogenic cysts don’t have any symptoms. Generally, symptoms only occur when one or more of the cysts grow large enough to place excess pressure on your airway or esophagus. Issues may also develop if the cysts become infected. Bronchogenic cyst symptoms may include:

• Respiratory problems.
• Fever.
• Hoarseness.
• Dysphagia (difficulty swallowing).

What causes bronchogenic cysts?

Bronchogenic cysts form during fetal development. However, experts don’t really know what causes them to develop in the first place. They’re not generally associated with chromosomal or genetic conditions.

How are bronchogenic cysts diagnosed?

Often, bronchogenic cysts are discovered during routine imaging tests. Your healthcare provider may use a variety of diagnostic tools depending on your age and unique situation.

Diagnosing bronchogenic cysts during pregnancy

During pregnancy, bronchogenic cysts may show up on prenatal ultrasounds. Your healthcare provider will monitor the size and growth of your baby’s cyst using ultrasound and magnetic resonance imaging (MRI).

Diagnosing bronchogenic cysts in children and adults

In children and adults, bronchogenic cysts may be found during routine chest X-rays. If your healthcare provider finds something suspicious, they may request additional tests, including:

• CT (computed tomography) scan. This advanced imaging test produces detailed X-ray images. In some cases, a contrast dye may be used to highlight suspicious areas.
• MRI (magnetic resonance imaging). This uses large magnets and radio waves to capture detailed images inside of your body.
• Esophagram. This imaging test combines a series of X-rays to provide a detailed look at your esophagus. You’ll be asked to drink a barium sulfate liquid while X-rays are taken of your swallowing process. This allows your healthcare provider to visualize any areas of suspicion.
• Bronchoscopy. After you’re given a sedative, your healthcare provider passes a bronchoscope (small tube with a camera attached) through your nose and into your main airway. In addition to checking the area for abnormalities, a small sample of tissue may also be taken for analysis (biopsy).

Can bronchogenic cysts be misdiagnosed?

Yes, it’s possible. Because bronchogenic cysts share many of the same symptoms as other conditions — including lung abscesses, tuberculosis or cystic teratomas — they may be misdiagnosed.

How is a bronchogenic cyst treated?

The most successful and widespread treatment for bronchogenic cysts is complete surgical removal. Fine needle aspiration (a procedure in which a long, thin needle is used to remove the affected cells) is sometimes used as an alternative treatment option. But cysts treated with this method are more likely to come back.

Treating bronchogenic cysts during pregnancy

Bronchogenic cysts that are discovered in utero (in the uterus) during pregnancy only require monitoring in most cases. In rare instances, a needle procedure may be used to drain the cyst.

Treating bronchogenic cysts in newborn babies

If the bronchogenic cyst isn’t causing serious problems at the time of delivery, then you’ll likely schedule a follow-up consultation with your healthcare provider who worked with you during your pregnancy.

Rarely, if the bronchogenic cyst is interfering with vital organ function, then surgery may be performed in the delivery room. Your baby will be partially delivered so that they are still receiving oxygen through the umbilical cord. This gives your fetal surgeon time to remove the cyst and establish an appropriate airway. Once this is achieved, your baby will be fully delivered.

Treating bronchogenic cysts in infants, children and adults

Babies, children and adults who show no symptoms at birth require long-term follow-up to monitor the size and location of their bronchogenic cysts. Surgical removal is usually recommended. Your healthcare provider may recommend:

• Thoracotomy. During this procedure, your surgeon creates an incision in your side, back or between your ribs. Next, they’ll access the bronchogenic cyst and remove it.
• Video-assisted thorascopic surgery (VATS). This minimally invasive option involves the use of a thorascope (a fiber-optic camera). This allows your surgeon to view the problem area without making large incisions. People who undergo VATS typically have a reduced risk for post-operative pain and infection.

Should bronchogenic cysts be removed?

Yes. Bronchogenic cysts should be removed whenever they are discovered, regardless of the person’s age. This greatly reduces the life-limiting complications that can arise.

Can I prevent bronchogenic cysts?

No. Because bronchogenic cysts are formed during fetal development, there is no known way to prevent them.

What can I expect if I have bronchogenic cysts?

If you or your baby has been diagnosed with a bronchogenic cyst, your healthcare provider will want to monitor the situation closely. Even small cysts have the potential to grow rapidly. Unless surgical risks are unusually high, bronchogenic cysts should be removed as soon as possible to avoid other, more serious complications.

Are bronchogenic cysts fatal?

While bronchogenic cysts aren’t fatal themselves, they can cause life-limiting problems in some cases. This occurs when the cyst grows and places pressure on surrounding structures, negatively affecting your breathing or other vital organ functions. Because bronchogenic cysts can sometimes grow rapidly, surgical removal is almost always recommended.

When should I see my healthcare provider?

Anytime you or your baby develop breathing problems, difficulty swallowing or hoarseness that won’t go away, you should schedule an appointment with your healthcare provider. They can run the appropriate tests to determine the root cause of your issue.

A note from Cleveland Clinic

Though rare, bronchogenic cysts can cause life-limiting problems in people of all ages. If you’ve been diagnosed with one, it’s best to remove it. Talk to your healthcare provider about your treatment options, and ask for resources that can help you make an informed decision regarding your long-term health.