Abstract

ABSTRACTManagement of asymptomatic mediastinal cysts in adults is controversial. In the past, these cysts were excised primarily to establish a diagnosis. Presently, computerized tomography (CT) of the chest can diagnose the majority of mediastinal cysts, based on their smooth contour and low density; however, CT diagnosis of a mediastinal cyst based on density can be erroneous. In six patients, we established the diagnosis of mediastinal cyst by percutaneous needle biopsy (PNB) without complication. In four of the patients, PNB was done as an outpatient procedure. Follow-up in five patients ranged from three months to three years, with no increase in the size of the cyst; in the sixth patient, surgical excision showed a hygroma. Thus, diagnosis of a mediastinal cyst can be safely confirmed by PNB. We suggest that these asymptomatic patients can be followed up without the need for surgical excision.