CTICasesBronchogenic Cyst with Congenital Absence of Right Upper Lobe Bronchus and Single Right Pulmonary Vein
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Imaging findings
Chest radiograph shows a subcarinal mass causing extrinsic compression and lifting of the right main bronchus. CT confirms a cystic subcarinal mass, consistent with a bronchogenic cyst, exerting mass effect on the esophagus. MRI demonstrates a bright signal within the cyst with a fluid level. Detailed review of CT angiography reveals an absent right upper lobe bronchus, with the bronchus intermedius bifurcating into the middle and lower lobes. A remnant fissure is noted. Additionally, a single right pulmonary vein is present, with all pulmonary venous return from the right lung draining through this common confluence.
Key takeaways
Bronchogenic cysts are foregut duplication cysts that commonly occur in the subcarinal region. Their presence can be associated with other congenital lung and vascular anomalies, such as absence of a lobar bronchus or anomalous pulmonary venous drainage. The cyst itself may represent a failed budding of an airway structure. Recognition of these associated anomalies is critical for surgical planning and avoiding complications during procedures like single-lung ventilation.
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