2. Department of Respirology, Chiba Aoba Municipal Hospital, Chiba, Japan.
3. Department of Pathology, Chiba University Hospital, Japan.
4. Department of Diagnostic Pathology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Background: The bronchial rupture of intrapulmonary cyst is very rare. We describe a case of bronchial rupture of intrapulmonary cyst which caused acute respiratory failure. A 31-year-old pregnant woman was taken to our hospital with acute respiratory failure. Chest radiography showed right atelectasis. After cesarean with endotracheal intubation, the atelectasis and respiratory failure immediately improved. However, several days later she was suffered with dyspnea with right atelectasis again. Bronchoscopy revealed necrotic material obstructing the right upper bronchus. After she continued to expectorate necrotic material, chest computed tomography revealed an empty cyst in the right upper lobe. Bronchoscopy showed cecal cystic bronchiectasis and absence of the B1/2 bronchi. We diagnosed as intrapulmonary cyst caused by the bronchial atresia of B1/2. Presuming that the contents of the ruptured intrapulmonary cyst caused acute respiratory failure, we performed a right upper lobectomy. Although intrapulmonary cysts are often asymptomatic, life-threatening rupture can occur suddenly. We believe that the cyst's potential for bronchial rupture is an indication for surgery.
Keywords: Intrapulmonary cyst, bronchial rupture, bronchial atresia, bronchial cyst