Cases reported "Mediastinal Cyst"

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1/10. Mediastinal pancreatic pseudocyst with recurrent pleural effusion. Demonstration by endoscopic retrograde cholangiopancreatogram and subsequent computed tomography scan.

    Mediastinal pseudocysts of internal pancreatic fistulas are rare as a cause of bilateral pleural effusions even in relapsing pancreatitis. We describe a 38-year-old man with recurrent bilateral pleural effusion as a complication of a pancreatic pseudocyst. Extension of a pancreatic pseudocyst into the posterior mediastinum was clearly identified by endoscopic retrograde cholangiopancreatogram and subsequent computed tomography scan of the abdomen and chest, and the complication was successfully treated by surgical management. We stress the importance of definite assessment of the communication of pancreatic pseudocyst with mediastinum in patients with pancreatitis who develop recurrent pleural effusions.
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2/10. Primary idiopathic chylopericardium associated with cervicomediastinal cystic hygroma.

    Chylopericardium is a rare clinical entity in which chylous fluid accumulates in the pericardial cavity. We report a case of primary idiopathic chylopericardium associated with multiple, small cervicomediastinal cystic hygromas occurring in an asymptomatic 43-year-old woman with no history of trauma, thoracic surgery, malignancy, infection or tuberculosis. echocardiography showed a large amount of pericardial effusions and pericardial fluid analysis revealed inappropriately elevated triglyceride. We did not demonstrate communication between the thoracic duct and the pericardial sac by lymphangiography and chest computed tomography. She successfully responded to 30 days of continuous pericardial drainage and 15 days of a medium-chain triglyceride diet after 30 days of total parenteral nutrition. Follow-up echocardiography 6 months after treatment commencement showed a minimal reaccumulation of pericardial fluid without symptom. We conclude that if a patient is asymptomatic and can well tolerate daily life, surgery including pericardiectomy or ligation of the thoracic duct is not necessarily required.
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3/10. Successful resolution of a mediastinal pseudocyst and pancreatic pleural effusion by endoscopic nasopancreatic drainage.

    CONTEXT: A mediastinal pseudocyst is an unusual complication of acute and chronic pancreatitis. The ideal form of management is controversial, and various successful therapeutic interventions including surgical resection, internal or external drainage, and non-operative radiological drainage techniques have been described. Successful resolution of a mediastinal pseudocyst with endoscopic transpapillary stent placement has been described in fewer than five cases. CASE REPORT: We report a case of chronic pancreatitis with complete pancreas divisum together with a mediastinal pseudocyst and pancreatic pleural effusion in which magnetic resonance imaging and endoscopic retrograde pancreatography demonstrated communication of the abdominal pseudocyst with the posterior mediastinum through the diaphragmatic hiatus. This case was successfully treated with endoscopic transpapillary nasopancreatic drain placement alone. CONCLUSION: A communicating mediastinal pseudocyst can be successfully treated by endoscopic transpapillary nasopancreatic drainage alone.
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4/10. Operative strategies in the management of mediastinal pancreatic pseudocyst.

    Thirty-four cases of mediastinal pancreatic pseudocyst have been previously reported. Among the 32 previous reports with operative or autopsy analysis, communication has been identified in 30. Even when this communication has been quite small between the mediastinal fluid collection and the pancreas, the recommended operative strategy has been enteric drainage directly to this communicating tract. We report the case of a patient with a mediastinal pancreatic pseudocyst in whom the communication between the pancreas and the pseudocyst was not located. The condition was managed by drainage of the mediastinal pseudocyst with decompression of the main pancreatic duct by means of a longitudinal pancreaticojejunostomy in a patient with chronic pancreatitis.
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5/10. Demonstration of an internal pancreatic fistula by computed tomography.

    The computed tomographic demonstration of a mediastinal pseudocyst communicating with the pancreatic duct in a patient with severe acute pancreatitis is reported. An awareness of this communication was essential in planning the appropriate surgical management.
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6/10. Thymopharyngeal duct cyst: MR imaging of a third branchial arch anomaly in a neonate.

    Third branchial arch anomalies are rare. The authors present a case report of a neonate with a rapidly growing neck mass due to cystic dilation of a persistent thymopharyngeal duct, which is a derivative of the third branchial arch. The presence of thyroid and thymic tissue in the cyst wall, the communication of the cyst with the piriform sinus, and the relationship of the cyst to carotid vessels and the sternomastoid muscle were consistent with the features of a thymopharyngeal duct cyst embedded in the thyroid gland.
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7/10. Paratracheal air cysts communicating with the trachea: CT findings.

    We reviewed the chest radiographic and thin-section computed tomography (CT) findings in three adult patients with air-filled paratracheal cysts communicating with the tracheal lumen. The air collections were located on the right side in each case. On plain radiographs, they appeared round or oval and were 1-2 cm in diameter. On CT scans, they appeared irregular with a small communication between the tracheal lumen and the cyst. Thin-section and three-dimensional reconstructed CT were useful in detecting the communication between the trachea and paratracheal cyst. In one case, the communication was recognized at surgical resection and in the other two cases, the orifice in the tracheal wall appeared as a tiny, well-circumscribed hole at fiberoptic bronchoscopy.
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8/10. thoracic duct cyst in supraclavicular region.

    A 28-year-old female attended an outpatient clinic in October, 1989, because of a tumor in the left supraclavicular fossa, detected in a health examination. Following exploratory puncture of the tumor which yielded milky-white fluid, suggesting a cyst in the thoracic duct, she was admitted to our department. The cyst was unilocular measuring about 6 cm in diameter, and the fluid content was chyle-rich in lipids. lymphography demonstrated a lymphatic structure adjacent to the lesion and scattered lymph vessels on the cyst surface. On November 16 the cyst was resected. A restiform structure was observed between the cyst and the thoracic duct, but the presence or absence of communication was unclear. The histological diagnosis was thoracic duct cyst. thoracic duct cyst occurring in the cervical region is very rare. Our case may provide useful information as to its pathogenesis and the mode of retention of cyst fluid.
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9/10. Extralobar pulmonary sequestration with an associated cyst of mixed bronchogenic and esophageal type--a case report.

    We report an unusual case of extralobar pulmonary sequestration (ELS) with an associated cyst of mixed bronchogenic and esophageal type. A 58-year-old woman was incidentally found to have a 6 x 6 x 5 cm sized mass in the right superior mediastinum. The mass consisted of sequestrated pulmonary tissue and an unilocular cyst with a direct communication. The cyst could not be easily classified because it was lined by squamous or respiratory epithelium with two distinct muscle layers and bronchial glands. Bronchial cartilage was present in close proximity to the ELS. This unusual combination of ELS with a foregut cyst might be a part of bronchopulmonary foregut malformation, attributed to a common embryologic pathogenesis.
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10/10. Mediastinal bronchogenic cyst: diagnosis and follow-up.

    A 5-year-old girl with an asymptomatic posterior mediastinal cyst from birth was followed with repeated echocardiograms. The cyst developed communication with the bronchus spontaneously around 8 months of age without clinical symptoms. This was detected from the sudden disappearance of the mass on echocardiogram, and an unusual air-pocket on chest roentgenogram. Computed tomography (CT) of the chest confirmed the diagnosis of communicating bronchogenic cyst (BC). She was treated successfully with complete surgical excision of the cyst and closure of the defect in the bronchus. We emphasize that surgery is indicated in all mediastinal BCs because of potential complications.
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