PMC3543967_01
A 21-year-old man with Mycobacterium avium infection combined with a bronchogenic cyst. (A) Chest radiography showed a cystic mass in the right upper lobe. (B) After anti-tuberculosis medication for 6 months, the mass increased in size and developed multiple cavities.
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F1
A cystic mass had been noticed on the chest radiograph at a routine health check 6 months earlier (Fig. 1A). However, the mass increased in size (Fig. 1B) and new symptoms developed, such as the cough and fever.
A 21-year-old man with Mycobacterium avium infection combined with a bronchogenic cyst. (A) Chest computed tomography (CT) revealed a multi-loculated cystic mass with bronchiolitis in the right upper lobe. (B) The resected right upper lobe showed an intrapulmonary bronchogenic cyst in the apical segment (arrow) and multiple cavitary necroses in the destroyed apical segment of the right upper lobe (arrowhead). (C) Microscopic findings of the multiple cavitary lesions revealed chronic granulomatous inflammation (the lesion is indicated by an arrowhead on the chest CT and gross findings) (H&E, x 100). (D) The microscopic findings of the bronchogenic cyst showed that the cyst was walled by ciliated columnar epithelium (the lesion is indicated by an arrow on chest CT and gross findings) (H&E, x 40).
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F2
A chest radiograph and computed tomography revealed a huge, multi-septated cystic mass in the right upper lobe (Fig. 2A). The resected lung contained a 2.5 x 2 cm intrapulmonary bronchogenic cyst and a 5 x 3.5 cm destructive cavitary lesion near the bronchogenic cyst in the right-upper lobe (Fig. 2B). Extensive granulomatous inflammation with caseous necrosis was found within the destructive cavitary lesion (Fig. 2C), and ciliated columnar epithelium without granuloma was found within the bronchogenic cyst (Fig. 2D).