Multimodality imaging of a rare intracardiac bronchogenic cyst

Figures

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  Fig. 1. EKG gated cardiac CT angiogram shows a well-circumscribed oval-shaped cystic mass (20 Hounsfield units) measuring 47 × 38 mm centered at the interatrial septum (*). No change in density was noted between the cardiac CT calcium score performed without iodinated contrast (not shown) and the CT angiogram, indicating absence of enhancement.

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  Fig. 2. Transesophageal echocardiogram. Side-by-side images without doppler (on the left) and with doppler (on the right) show the presence of a well-defined anechoic cystic mass centered at the interatrial septum (*). Absence of doppler flow confirms the cystic nature of the lesion (image on the right).

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  Fig. 3. Cardiac MRI (1.5 Tesla) images showing the well-defined ovoid interatrial lesion (yellow arrow). (A) Balanced turbo field echo (BTFE) 4 chamber cine image (10 mm thickness) confirms the well-defined nature of the lesion with a homogenous slightly hyperintense signal. (B) Black blood proton density short axis image (8 mm thickness) with fat saturation shows the homogenous slightly hyperintense signal of the lesion. The lack of signal loss with fat saturation confirms the lack of fat contents within the lesion and excludes lipomatous lesions and lipomatous hypertrophy from the differential diagnosis. (C) 2D Phase sensitive inversion recovery (PSIR) single shot short axis image (10 mm thickness) acquired 10 minutes following injection of intravenous gadolinium confirms lack of enhancement and cystic nature of the lesion.

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  Fig. 4. Microphotographs at low magnification (A) and high magnification (B) showing the surface of the cystic lesion covered by pseudostratified ciliated epithelial lining (arrow).