S Afr J Surg
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This case highlights an unusual pleural cyst in a 3-year-old child that simulated a pneumothorax on chest radiograph. The child presented with mild respiratory distress and the 'pneumothorax' failed to respond to pleural intubation. At thoracotomy, a 10 cm air-filled cyst was found attached to the visceral pleura by a narrow pedicle. ⋯ Postoperatively, the lung expanded and the child recovered without any sequelae. Histological examination of the cyst showed it to be lined with mesothelial cells. It is suggested that this cyst arose from a mesothelial inclusion cyst or sub-mesothelial pleural tissue, which communicated with the peripheral lung tissue.