Case Of the Week (COW) 19 April 2015
PRENATAL DIAGNOSIS OF POSTERIOR MEDIASTINAL CYST
Findings
Anechoic cyst in the posterior mediastinum which is anterior to aorta pushing both the lungs and heart anteriorly. Adjacent spine appear normal.Heart and lungs appear normal. liver ,Both kidneys appear normal. stomach bubble on the left side.
Discussion
Diagnosis made as posterior mediastinal cyst Differntial diagnosis considered : 1.Neuro enteric cyst 2.Bronchogenic cyst Bronchogenic cysts range in size from a few millimeters to more than 5 cm. On prenatal ultrasound, they usually appear as anechoic unilocular intrathoracic cysts at times with layering echogenic material. If the cyst does not cause mass effect, it typically will not cause a problem in utero. Neurenteric cysts represent a posterior enteric remnant caused by incomplete separation of the notochord from the foregut during embryogenesis. They typically occur in the posterior mediastinum or in the spinal canal. The cysts can have a septated or bilobed appearance. Associated spinal abnormalities are typically present.
DIFFERENTIAL DIAGNOSIS OF CYSTIC LESION IN FETAL THORAX ABNORMALITY DISTINGUISHING FEATURES
1.Congenital cystic adenomatoid - echogenic lung mass with cyst malformation
2.congenital diaphraghmatic hernia - bowel peristalsis in chest(unilateral)
3.Teratoma-Mass does not obey lobar boundaries; may have calcifications
4.Neurenteric cyst-Adjacent to spine
5.Bronchogenic cyst-typically single cyst in subcarinal region
6.Esophageal duplication-Adjacent to esophagus
7.Lymphangioma-Crosses anatomic boundaries
Contributed By:
Prof. N Kailasanathan, Dr. K Sivakumar
Barnard Institute of Radiology
PRENATAL DIAGNOSIS OF POSTERIOR MEDIASTINAL CYST
Findings
Anechoic cyst in the posterior mediastinum which is anterior to aorta pushing both the lungs and heart anteriorly. Adjacent spine appear normal.Heart and lungs appear normal. liver ,Both kidneys appear normal. stomach bubble on the left side.
Discussion
Diagnosis made as posterior mediastinal cyst Differntial diagnosis considered : 1.Neuro enteric cyst 2.Bronchogenic cyst Bronchogenic cysts range in size from a few millimeters to more than 5 cm. On prenatal ultrasound, they usually appear as anechoic unilocular intrathoracic cysts at times with layering echogenic material. If the cyst does not cause mass effect, it typically will not cause a problem in utero. Neurenteric cysts represent a posterior enteric remnant caused by incomplete separation of the notochord from the foregut during embryogenesis. They typically occur in the posterior mediastinum or in the spinal canal. The cysts can have a septated or bilobed appearance. Associated spinal abnormalities are typically present.
DIFFERENTIAL DIAGNOSIS OF CYSTIC LESION IN FETAL THORAX ABNORMALITY DISTINGUISHING FEATURES
1.Congenital cystic adenomatoid - echogenic lung mass with cyst malformation
2.congenital diaphraghmatic hernia - bowel peristalsis in chest(unilateral)
3.Teratoma-Mass does not obey lobar boundaries; may have calcifications
4.Neurenteric cyst-Adjacent to spine
5.Bronchogenic cyst-typically single cyst in subcarinal region
6.Esophageal duplication-Adjacent to esophagus
7.Lymphangioma-Crosses anatomic boundaries
Contributed By:
Prof. N Kailasanathan, Dr. K Sivakumar
Barnard Institute of Radiology