CTICasesHyperdense Bronchogenic Cyst (with Milk of Calcium)
Imaging findings
Frontal chest radiograph shows a subtle density in the subcarinal region, which is better delineated on the lateral view as a soft tissue mass with a layering high-density interface. Chest CT demonstrates a well-defined, hyperdense subcarinal mass conforming to the contours of the mediastinum, containing layering hyperdense material (milk of calcium) and a small portion of low-attenuation lipid or proteinaceous fluid.
Key takeaways
Bronchogenic cysts are congenital foregut duplication cysts that are frequently hyperdense on CT due to high proteinaceous or mucoid content. They can be confidently diagnosed and differentiated from solid neoplasms when they conform to adjacent mediastinal structures without causing mass effect, or when they demonstrate characteristic internal features such as layering 'milk of calcium'.
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