An incidental finding in a 34-year-old male under investigation for haemoptysis. Diagnosis: The radiological and endoscopic images demonstrate a complex defect along the posterior tracheal wall consistent with acquired tracheal diverticulum

Posterior Tracheal Diverticulum in a Patient Undergoing Tonsillectomy

This case report describes a male patient in his 20s who presented with bilateral palatine tonsil enlargement and history of infections 4 to 5 times per year and was subsequently found to have tracheal diverticulum.

Paratracheal air cysts: prevalence and relevance to pulmonary emphysema and bronchiectasis using thoracic multidetector CT

PURPOSE

We aimed to determine the prevalence of paratracheal air cysts (PTACs) and the relationship of PTACs with emphysema and bronchiectasis through retrospective analysis of multidetector computed tomography (MDCT) findings.

METHODS

MDCT findings of 1027 consecutive patients who underwent routine thorax examination between January 2012 and January 2013 were evaluated retrospectively for the presence of PTACs. Localization of the PTACs, as well as their size, shape, and relationship with the trachea were examined. Presence of emphysema and bronchiectasis was recorded, and bronchiectasis severity index was calculated when present. We randomly selected 80 patients who had no visible PTACs as the control group. The findings of patients with and without PTACs were compared.

RESULTS

PTACs were determined in 82 of 1027 patients (8%), in 8.8% of females and 7.3% of males. The presence of PTACs was determined to be independent of gender (P = 0.361). Eighty-one PTACs (98.8%) were located in the right side of the trachea and 56.1% had a tracheal connection. The presence of PTACs significantly correlated with the presence and severity of bronchiectasis (P = 0.001 and P = 0.005 respectively). There was no significant relationship between the presence of PTACs and the presence of emphysema on CT images (P = 0.125).

CONCLUSION

The prevalence of PTACs was determined as 8% in this study. There was significant association between PTACs and bronchiectasis.

Transcervical resection of tracheal diverticulum

Tracheal diverticulum is a clinical entity rarely reported in the literature. It can be congenital or acquired in origin, and most cases are asymptomatic, usually being discovered incidentally at CT scan. Therefore, treatment has not been widely reported. We present the case of a 30-year-old man with a 6-month history of repeatedly coughing and tracheobronchitis. CT scanning revealed the lesion. The patient underwent surgical resection of the tracheal diverticulum via a transcervical approach. Symptoms resolved after surgical treatment. Reexamination of the neck, chest, trachea, and lungs of the patient was performed with CT scan postoperative. © 2016 Wiley Periodicals, Inc. Head Neck 39: 187-190, 2017.

Air column beside the trachea

A 60-year-old man, a non-smoker, was referred to us for evaluation of an abnormal chest radiograph that had been taken 2 months earlier when the patient had fever and cough. The fever and cough had subsided after treatment with antibiotics. The patient was asymptomatic at the time of presentation to us. Examination was unremarkable. The chest radiograph showed an air pocket in the right paratracheal region. The diagnosis and differential diagnoses are discussed in this case report.

Infected tracheal diverticulum: a rare association with alpha-1 antitrypsin deficiency

Tracheal diverticulum, defined as a benign outpouching of the tracheal wall, is rarely diagnosed in clinical practice. It can be congenital or acquired in origin, and most cases are asymptomatic, typically being diagnosed postmortem. We report a case of a 69-year-old woman who was hospitalized after presenting with fever, fatigue, pleuritic chest pain, and a right neck mass complicated by dysphagia. Her medical history was significant: pulmonary emphysema (alpha-1 antitrypsin deficiency); bronchiectasis; and thyroidectomy. On physical examination, she presented diminished breath sounds and muffled heart sounds, with a systolic murmur. Laboratory tests revealed elevated inflammatory markers, a CT scan showed an air-filled, multilocular mass in the right tracheal wall, and magnetic resonance imaging confirmed the CT findings. Fiberoptic bronchoscopy failed to reveal any abnormalities. Nevertheless, the patient was diagnosed with tracheal diverticulum. The treatment approach was conservative, consisting mainly of antibiotics. After showing clinical improvement, the patient was discharged.

Infected tracheocoele (acquired tracheal diverticulum): case report and literature review

BACKGROUND

Paratracheal air-filled cysts are rare. Tracheocoele or acquired tracheal diverticulum is the term given to these acquired abnormalities, which usually arise in adults. The majority is asymptomatic, being discovered as incidental findings on radiological imaging.

METHODS

We report the case of a 72-year-old man with a previously identified tracheocoele which became symptomatic following an upper respiratory tract infection. A literature is presented and nomenclature is discussed.

RESULTS

The clinical presentation, differential diagnosis and management of paratracheal air-filled cysts are discussed.

CONCLUSION

While most of these rare abnormalities are discovered incidentally, this case illustrates the fact that significant symptoms can develop; excision should therefore be considered.

A right paratracheal air cyst caused by tracheal diverticula

A 65-year-old woman presented with pain in her throat and neck. Thin-section computed tomography (CT) revealed an air-filled lesion at the right paratracheal region and two narrow connections to the trachea. Flexible bronchoscopy showed four diverticula 4-5 cm below the vocal cords in the right lateral part of the trachea. Consistent with the CT findings, two of the diverticula were deep. A radiological barium swallow study and an esopagogastroduodenal endoscopic examination revealed no abnormalities. We therefore believe that her right paratracheal air cyst is an extension of a tracheal diverticulum. Right-sided paratracheal air cysts at the level of the thoracic inlet are a common finding on CT and should not be confused with pneumomediastinum in order to avoid unnecessary examinations or treatments.