A 54-year-old woman complained of cough and then was diagnosed with interstitial pneumonia. Computed tomography showed upper-lobe dominant pulmonary fibrosis (Upper-PF), pneumomediastinum (arrowhead), and air cyst around the carina (closed arrow) (Picture 1A-C). After five years, she showed progressive fibrotic changes and an enlarged mediastinal cyst (closed arrow) without a history of mediastinitis (Picture 1D-F). Bronchoscopy confirmed a hole, which indicated an air cyst as the right main bronchial diverticulum (Picture 2) (B: High-power view of the dashed square in A). Most airway diverticula are located in the right posterolateral region of the trachea and are a rare disorder that is often asymptomatic and usually detected incidentally by radiography (1). Only one case of bronchial diverticulum has been reported besides our patient, and that case was also associated with Upper-PF (2). Clinicians should recognize that the mechanical traction and vulnerability in cases of Upper-PF might play a role in inducing pneumomediastinum or bronchial diverticula.
Picture 1.
Picture 2.
The authors state that they have no Conflict of Interest (COI).
References
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