Welcome to Cross-Canada Paediatric - Respiratory Residency Rounds

CONTINUED from page 10


a) Diagnostic Imaging:

i) Characteristic CXR findings:
- one or more round/oval masses
- homogenous
- smooth borders
- normal surrounding lung

May see:
- pleural reaction
- atelectasis or mediastinal shift
- lobulated cyst edges if impingement on relatively rigid anatomical structures

- calcification rarely seen

Special signs uncommonly seen:
- "crescent sign" (air between the pericyst and exocyst)
- "Cumbo's sign" (parallel arches of air outlining the inner surface of the cyst
- "waterlily sign" (if the ruptured cyst communicates with the tracheobronchial tree, there can be evacuation of the contents of the cyst, and an air-fluid level can be seen with the endocyst appearing to float in the remaining fluid)

ii) CT scan
- round cysts, homogeneous contents
- density of water
- thin, enhancing rim if cyst intact
- occasionally see "daughter" cysts MRI has no advantage over CT scan, however may have a role in investigating liver cysts in the identification of changes in the intra and extrahepatic venous systems)

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