Role of Endobronchial Ultrasound in the Diagnosis and Management of Bronchogenic Cysts: Two Case Descriptions and Literature Review

Imaging studies, such as high resolution computerized tomography (HRCT) and magnetic resonance imaging (MRI) facilitate the evaluation of mediastinal masses. However, the definite characterization of such masses can be ascertained only after tissue sampling is obtained and analyzed. Some mediastinal masses, like bronchogenic cysts, can be misdiagnosed as solid masses or lymphadenopathy in imaging studies, due to the variable densities of the cyst contents. More invasive tests, like fine needle aspiration or surgical resection of the bronchogenic cyst, may be necessary when HRCT fails to provide an initial diagnosis. We describe two such cases seen at our institution that highlight the implications of establishing a diagnosis of bronchogenic cyst with endobronchial ultrasound (EBUS) trans-bronchial needle aspiration (TBNA) and discuss the possible therapeutic utility of EBUS-TBNA in select patients with bronchogenic cysts. Abbreviation List BAL Bronchoalveolar lavage CNS Coagulase-negative Staphylococcus CT – Computed tomography EBUS Endobronchial ultrasound EUS – Endoscopic ultrasound FOB Fiberoptic bronchoscopy HRCT High resolution computerized tomography MRI Magnetic resonance imaging RUL – Right upper lobe TBNA Trans-bronchial needle aspiration VATS Video-assisted thoracoscopic surgery