CTICasesBronchogenic Cyst
Imaging findings
Chest radiograph shows a right paratracheal mass causing leftward mass effect on the trachea, displaying the cervical-thoracic sign where its upper margin fades as it rises above the clavicles. CT and MRI confirm a vertically oriented, multi-lobulated, high-attenuation cystic lesion with focal rim calcification and high T1 and T2 signal, consistent with proteinaceous or hemorrhagic fluid, and no internal enhancement.
Key takeaways
Bronchogenic cysts are congenital foregut duplication anomalies that can remain asymptomatic and unrecognized until adulthood. While classically presenting as homogeneous fluid-density masses in the subcarinal or paratracheal regions, they can exhibit high attenuation on CT and variable T1/T2 signal on MRI due to proteinaceous debris, hemorrhage, or calcium oxalate ("milk of calcium").
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