Large air-filled intrapulmonary bronchogenic cyst associated with tension pneumothorax during air travel

A 38-year-old woman developed a spontaneous right-sided tension pneumothorax during light aircraft travel. The aircraft was diverted to a regional centre, where emergent needle thoracostomy and chest tube insertion were performed. History suggested that this was the second episode of pneumothorax, with an untreated event with similar symptomatology during air travel 1 year ago. She was taken for surgical intervention. Intraoperative findings were of a large right middle lobe cyst of uncertain origin; the procedure was subsequently aborted. A CT chest demonstrated a large multiseptated air-filled pulmonary cystic lesion. Inpatient stay was notable for persistent right pneumothorax with interval cyst rupture. A right middle lobectomy was subsequently performed with histopathology showing a benign epithelioid bronchogenic cyst. Recovery was unremarkable with no residual pneumothorax or further episodes at 2 months postoperatively. Preventative excision of air-filled pulmonary abnormalities should be considered prior to air travel.