CTICasesSuperinfected Bronchogenic Cyst
Imaging findings
CT demonstrates a middle mediastinal low-attenuation (20-25 HU) mass adjacent to the esophagus and posterior to the aortic arch, showing progressive enlargement. Following an EUS-guided drainage attempt, the mass dramatically enlarged with surrounding mediastinal fat stranding and pleural effusions, consistent with superinfection.
Key takeaways
Biopsy or aspiration of a benign mediastinal bronchogenic cyst can introduce esophageal/airway flora, leading to superinfection, rapid enlargement, and acute mediastinitis.
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