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Selvaratnam R, Srirangalingam U, Mclean E, Lang-Lazdunski L, Goulden P. A rare cause of acute chest pain in a young adult. Clin Med (Lond) 2011; 11:265-7. [PMID: 21902082 PMCID: PMC4953322 DOI: 10.7861/clinmedicine.11-3-265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Turan O, Hirfanoğlu IM, Beken S, Biri A, Efetürk T, Atalay Y. Prenatally detected congenital cystic adenomatoid malformation and postnatally diagnosed trisomy 13: case report and review of the literature. Turk J Pediatr 2011; 53:337-341. [PMID: 21980820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Congenital cystic adenomatoid malformation (CCAM) is a rare bronchopulmonary malformation characterized by loss of the normal pulmonary tissue. CCAM may be frequently associated with cardiac and renal anomalies. Rarely, CCAM may be seen with chromosome abnormalities. This is the first reported neonatal case of prenatally detected CCAM and postnatally diagnosed trisomy 13.
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Takrouri MSM, Maghaireh A, Obeidat MR. Anesthesia experience in a child affected by congenital cystic adenomatoid malformation and retinopathy of prematurity for eye laser procedure--a case report. MIDDLE EAST JOURNAL OF ANAESTHESIOLOGY 2011; 21:115-118. [PMID: 21991743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Congenital Cystic Adenomatoid Malformation or bronchopulmonary displasia (congenital lung cysts disease) is a rare condition. Intrauterine death affect severe cases, those infants surviving till birth lead a chronic course of respiratory illness amenable to corrective thoracic surgery or other corrective measures for non pulmonary conditions. This report describes an experience with one girl that needed anesthesia for congenital retinopathy's laser treatment.
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Kuratsuji G, Hokuto I, Higuchi M, Koinuma G, Morikawa Y, Hoshino K, Tanaka M, Miyakoshi K, Ikeda K. Final diagnosis in patients with congenital cystic lung disease detected by fetal ultrasonography. Pediatr Int 2011; 53:131-2. [PMID: 21342346 DOI: 10.1111/j.1442-200x.2010.03301.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sirithangkul S, Chuengchitraks S, Staworn D, Laohapand C, Silarat T. Late manifestation of congenital cystic adenomatoid malformation with lung abscess: a case report. JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND = CHOTMAIHET THANGPHAET 2010; 93 Suppl 6:S223-S227. [PMID: 21280540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Congenital cystic adenomatoid malformation (CCAM) is a rare congenital cystic abnormality of the lung. Most of cases are usually diagnosed and managed in the newborn period even though some are asymptomatic and present in childhood or adult. The authors report a 7-year-old girl who presented with chronic cough, hemoptysis and clubbing of fingers. Physical examination revealed decreased breath sound and dullness on percussion at right upper chest. A chest radiograph showed a large thin-walled cyst with air fluid and a small thin-walled cyst occupied the whole right upper lobe. Computed tomography (CT) of the chest showed two large thin-walled cavities with air fluid level in the right upper lobe with few small cavities nearby. She was given antibiotics and cardiovascular and thoracic surgeon was consulted. The patient underwent right upper lobectomy. Microscopic examination was compatible with CCAM type 1. The post operative course was uneventful and the recovery was complete. She continued to be healthy at a follow-up visit about 8 months postoperatively but chest radiograph showed soft tissue density at right upper lung field. Chest CT findings were compatible with recurrent CCAM. A follow-up chest radiograph at 13 months postoperatively showed significant reduction in size of the lesion.
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Tomita SS, Wojtczak H, Pickard R, Vazquez WD. Congenital cystic adenomatoid malformation and bronchogenic cyst in a 4-month-old infant. Ann Thorac Cardiovasc Surg 2009; 15:394-396. [PMID: 20081749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Accepted: 12/11/2008] [Indexed: 05/28/2023] Open
Abstract
Congenital cystic disease of the lung and mediastinum encompasses a continuum of entities, and a histological overlap of many of these anomalies is acknowledged. Moreover, it is possible for different lesions to coexist in the same patient. Careful evaluation prior to surgical resection will alert the surgeon to the possible presence of multiple lesions in one patient.
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Fang HQ, Li QM, Tao X. [Adult congenital cystic adenomatoid malformation of lung co-existing with carcinoid: report of a case]. ZHONGHUA BING LI XUE ZA ZHI = CHINESE JOURNAL OF PATHOLOGY 2008; 37:713-715. [PMID: 19094495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Hüsler MR, Wilson RD, Rychik J, Bebbington MW, Johnson MP, Mann SE, Hedrick HL, Adzick S. Prenatally diagnosed fetal lung lesions with associated conotruncal heart defects: Is there a genetic association? Prenat Diagn 2007; 27:1123-8. [PMID: 17787025 DOI: 10.1002/pd.1845] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
UNLABELLED Congenital lung malformation can easily be diagnosed by prenatal ultrasound. Associated extrapulmonary malformations such as heart defects and chromosomal aberrations are rare. OBJECTIVE The objective of this study was to describe the natural history, outcome and other associated malformations in fetuses with lung lesions and an associated heart defect. METHODS Retrospective analysis of 4 cases of prenatally diagnosed fetal CCAMs and hybrid lesions with an associated heart defect and review of 8 cases in the literature. RESULTS At a single referral center 1.9% of the fetuses with Congenital cystic adenomatoid malformation (CCAM) were diagnosed with an associated heart defect. Seven of the total 12 cases (58%) reviewed had a conotruncal heart abnormality. Chromosomal abnormalities were found in 5 (42%) of the cases. CONCLUSION This retrospective review shows that karyotyping in fetal lung lesions with an associated heart defect or isolated large lung lesions is indicated. It also suggests that there is a subpopulation of fetuses with CCAMs who have conotruncal heart defects. This finding may suggest a common genetic background.
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Vu L, Tsao K, Lee H, Nobuhara K, Farmer D, Harrison M, Goldstein RB. Characteristics of congenital cystic adenomatoid malformations associated with nonimmune hydrops and outcome. J Pediatr Surg 2007; 42:1351-6. [PMID: 17706495 DOI: 10.1016/j.jpedsurg.2007.03.039] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND/PURPOSE In fetuses with congenital cystic adenomatoid malformations of the lung (CCAMs), hydrops fetalis and large masses are associated with poor outcomes. This study attempts to (1) determine sonographic features (in addition to large size) that correlate with hydrops and (2) characterize the features that correlate with outcome among hydropic fetuses. METHOD Charts and sonograms of fetuses with large, unilateral CCAMs were retrospectively reviewed. Mass features evaluated included laterality, macrocystic/microcystic, cystic/solid predominance, degree of mediastinal shift, retrocardiac component, diaphragm eversion, polyhydramnios, and mass-thorax ratio (MTR). Features of hydrops included degree of ascites, scalp and integumentary edema, pleural/pericardial effusion, and placentomegaly. RESULTS Thirty-six fetuses with large CCAMs were studied: 27 with and 9 without hydrops. Three sonographic features were significantly associated with hydrops: MTR of at least 0.56, cystic predominance of mass, and eversion of hemidiaphragm. Of 27 fetuses with hydrops, 10 (37%) demonstrated all 3 features compared with none in those without hydrops (P = .04). All 9 nonhydropic fetuses were expectantly managed, and 100% survived. In the hydropic group, none of the expectantly managed fetuses survived, and 10 (43%) of the 21 fetuses who underwent fetal intervention survived. CONCLUSION Three features of large CCAMs were significantly associated with hydrops: MTR, cystic predominance, and diaphragm eversion. Identification of these features will allow clinicians to accurately predict which fetuses may warrant closer follow-up and possible treatment.
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Lantuejoul S, Nicholson AG, Sartori G, Piolat C, Danel C, Brabencova E, Goldstraw P, Brambilla E, Rossi G. Mucinous Cells in Type 1 Pulmonary Congenital Cystic Adenomatoid Malformation as Mucinous Bronchioloalveolar Carcinoma Precursors. Am J Surg Pathol 2007; 31:961-9. [PMID: 17527088 DOI: 10.1097/01.pas.0000249444.90594.27] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Type 1 congenital cystic adenomatoid malformation (CCAM), the most frequent malformation of the lung, is the only type to present intracystic mucinous cell clusters, which may form beyond the cysts extracystic mucinous proliferation resembling mucinous bronchioloalveolar carcinomas (BACs). As mucinous BACs are increasingly described in the literature in young patients with CCAM, we hypothesized that type 1 CCAM mucinous cells could represent BAC precursors. We reviewed 7 cases of type 1 CCAM including 6 with intracystic mucinous cell clusters, 3 with extracystic mucinous proliferations, and 4 with mucinous BAC or mixed adenocarcinoma with predominant BAC. K-ras mutations at codon 12 were detected in 3/3 intracystic mucinous cell clusters, in 2/3 extracystic mucinous proliferations, and in 3/4 BAC. Loss of heterozygosity (LOH) at p16(INK4) locus, with microsatellite alterations in 3 cases, was observed in 2/3 intracystic mucinous cell clusters, in 2/3 extracystic mucinous proliferations, and in all BAC. Two extracystic mucinous proliferations showed LOH at FHIT and Rb loci, respectively. P16(INK4) expression was lost in 2 intracystic mucinous cell clusters, 1 extracystic mucinous proliferation, and 1 BAC. Neither epidermal growth factor receptor mutation on exons 18, 19, and 21 nor P53 accumulation was observed. All lesions expressed MUC5AC, but were negative for MUC2, CDX2, and TTF-1. In conclusion, type 1 CCAM mucinous cells share the same differentiation profile with corresponding mucinous BAC, consistent with a common bronchial origin. Moreover, the high frequency of K-ras mutation and LOH and/or microsatellite alterations at p16(INK4) locus presented by these mucinous cells justifies their consideration as BAC precursors.
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MESH Headings
- Adenocarcinoma, Bronchiolo-Alveolar/etiology
- Adenocarcinoma, Bronchiolo-Alveolar/genetics
- Adenocarcinoma, Bronchiolo-Alveolar/pathology
- Adenocarcinoma, Mucinous/etiology
- Adenocarcinoma, Mucinous/genetics
- Adenocarcinoma, Mucinous/pathology
- Adolescent
- Adult
- Child
- Child, Preschool
- Cystic Adenomatoid Malformation of Lung, Congenital/complications
- Cystic Adenomatoid Malformation of Lung, Congenital/genetics
- Cystic Adenomatoid Malformation of Lung, Congenital/pathology
- Female
- Humans
- Immunohistochemistry
- Immunophenotyping
- Infant
- Loss of Heterozygosity
- Male
- Microsatellite Repeats
- Middle Aged
- Mutation
- Polymerase Chain Reaction
- Precancerous Conditions/complications
- Precancerous Conditions/genetics
- Precancerous Conditions/pathology
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Armstrong R, Fryer A, Pisipati S, Jesudason E. Evaluating the association between congenital cystic adenomatoid malformation of the lung and abdominal wall laxity. Clin Dysmorphol 2007; 16:77-80. [PMID: 17351348 DOI: 10.1097/mcd.0b013e328014724e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We report a male fetus with congenital cystic adenomatoid malformation of the lung, who was treated by laser with resolution of hydrops. Postnatally, the infant had the typical abdominal wall laxity and undescended testes characteristic of prune-belly syndrome. The sonographic diagnosis of cystic adenomatoid malformation was confirmed histologically after postnatal resection. The relationship between cystic adenomatoid malformation and prune-belly syndrome is evaluated through analysis of the present and previously reported cases. We show that there does appear to be a true association between cystic adenomatoid malformation and prune-belly syndrome. We also, however, demonstrate that the traditional explanation (cystic adenomatoid malformation-related hydrops causes ascitic abdominal distension resulting in prune-belly syndrome) is unlikely to be straightforwardly correct.
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West D, Nicholson AG, Colquhoun I, Pollock J. Bronchioloalveolar carcinoma in congenital cystic adenomatoid malformation of lung. Ann Thorac Surg 2007; 83:687-9. [PMID: 17258019 DOI: 10.1016/j.athoracsur.2006.06.029] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2006] [Revised: 05/30/2006] [Accepted: 06/05/2006] [Indexed: 10/23/2022]
Abstract
Congenital cystic adenomatoid malformation (CCAM) of lung is a rare condition with the potential for malignant transformation. We report a patient who underwent lobectomy for a cystic lung lesion, which was found to be a type 1 CCAM associated with a mucinous bronchioloalveolar carcinoma. Retrospective review of a biopsy specimen from the same lobe excised during an ipsilateral empyema drainage 11 years previously showed similar foci of bronchioloalveolar carcinoma. The patient remains well 3 years after surgery. This case demonstrates the indolent nature of malignancies seen in association with type 1 CCAMs and also that complete excision, probably by lobectomy, is the treatment of choice to avoid recurrence.
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Pai S, Eng HL, Lee SY, Hsaio CC, Huang WT, Huang SC, Hill DA, Dehner LP, Priest JR. Correction: Pleuropulmonary blastoma, not rhabdomyosarcoma in a congenital lung cyst. Pediatr Blood Cancer 2007; 48:370-1. [PMID: 16856157 DOI: 10.1002/pbc.20965] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Aslan AT, Yalcin E, Soyer T, Dogru D, Talim B, Ciftci AO, Ozcelik U, Kiper N. Prenatal period to adolescence: the variable presentations of congenital cystic adenomatoid malformation. Pediatr Int 2006; 48:626-30. [PMID: 17168986 DOI: 10.1111/j.1442-200x.2006.02264.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Congenital cystic adenomatoid malformation (CCAM) of the lung is a rare but potentially life-threatening pulmonary anomaly. METHODS Seven patients operated on with the diagnosis of CCAM were reviewed to determine the clinical presentation, age at diagnosis, histopathologic types and the postoperative course. RESULTS Cough and respiratory distress were common clinical findings in the patients in the present study. Two of the patients had congenital respiratory distress. The patient who was diagnosed at 15 years had cough, hemoptysis and anorexia for the last 4 months. One patient who received the diagnosis of CCAM prenatally was asymptomatic until she was operated on, on the 45th postnatal day. All patients but one were operated on and histopathological diagnosis was made for each of them between the ages of 4 days to 12 months. Four patients were diagnosed as having CCAM type I, and three patients had CCAM type II histopathologically. Duration of postoperative follow up was between 3 months and 15 years. Neither patient had complaints during that period. CONCLUSION CCAM can present at different ages and in various clinical presentations. There can even be asymptomatic patients who receive their diagnosis during the prenatal period. The possibility of an underlying CCAM should be considered in infants with recurrent chest infections or persistent abnormalities on chest X-ray following an acute infection. CCAM should also be considered in cases with lung abscess, even in adolescents with no past history of pulmonary complaints.
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Keller RL, Moore P, Teitel D, Hawgood S, McQuitty J, Fineman JR. Abnormal vascular tone in infants and children with lung hypoplasia: Findings from cardiac catheterization and the response to chronic therapy. Pediatr Crit Care Med 2006; 7:589-94. [PMID: 17006391 DOI: 10.1097/01.pcc.0000244401.53189.cb] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We describe four cases of chronic pulmonary hypertension in infants and children with chronic lung disease and pulmonary hypoplasia due to severe congenital diaphragmatic hernia (CDH) or congenital cystic adenomatoid malformation (CCAM). We report data from cardiac catheterization under various conditions: baseline respiratory support and room air, hyperoxic and inhaled nitric oxide challenge. We further report cardiac catheterization measures after chronic pulmonary vasodilator therapy with sildenafil alone or a combination of sildenafil and inhaled nitric oxide (three patients). DESIGN Case series. SETTING Tertiary academic center. PATIENTS Infants and children ages 0-11 yrs with CDH (n = 3) or CCAM (n = 1) with evidence of chronic pulmonary hypertension by echocardiogram and cor pulmonale (n = 3). INTERVENTIONS Catheterization and pulmonary vasodilator therapy. MEASUREMENTS AND MAIN RESULTS Pulmonary vascular resistance, pulmonary arterial pressure, and changes in these measures were assessed. A 20% change in pulmonary vascular resistance was considered a clinically significant response. Ten catheterizations were performed in four patients. All patients had elevated pulmonary vascular resistance and pulmonary arterial pressures at initial catheterizations and significant vasodilation during inhaled nitric oxide. CONCLUSIONS Chronic lung disease following pulmonary hypoplasia from CDH and CCAM is associated with abnormal pulmonary vascular tone in infants and children with evidence of chronic pulmonary hypertension. Chronic pulmonary vasodilator therapy may improve pulmonary vascular function and enhance lung growth in infants and children who are treated during their period of potential for rapid lung growth.
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41
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Dhamrait RS. Fasciotomy following intravenous fluid infiltration. Paediatr Anaesth 2006; 16:1097. [PMID: 16972848 DOI: 10.1111/j.1460-9592.2006.01960.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chadha R, Singh D, Kathuria P, Sharma S, Choudhury SR, Jain M. Congenital cystic adenomatoid malformation associated with ipsilateral eventration of the diaphragm. Indian J Pediatr 2006; 73:832-4. [PMID: 17006045 DOI: 10.1007/bf02790396] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
A two-month-old girl was operated for a left-sided eventration of the diaphragm. At surgery, a mass representing an extralobar pulmonary sequestration (EPS) was found inferior to the left lobe of the lung and was excised. Histopathological examination of the resected specimen showed presence of a type II congenital cystic adenomatoid malformation (CCAM) within it. A review of the relevant literature is presented.
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Riedlinger WFJ, Vargas SO, Jennings RW, Estroff JA, Barnewolt CE, Lillehei CW, Wilson JM, Colin AA, Reid LM, Kozakewich HPW. Bronchial atresia is common to extralobar sequestration, intralobar sequestration, congenital cystic adenomatoid malformation, and lobar emphysema. Pediatr Dev Pathol 2006; 9:361-73. [PMID: 16953677 DOI: 10.2350/06-01-0023.1] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2006] [Accepted: 03/02/2006] [Indexed: 01/03/2023]
Abstract
Congenital cystic adenomatoid malformation (CCAM), intralobar sequestration (ILS), extralobar sequestration (ELS), and lobar emphysema (LE) are well-accepted entities; however, certain findings are common to all, particularly the parenchymal maldevelopment characterizing CCAM. Isolated reports have described bronchial atresia (BA) in some specimens in all 4 entities, but this finding has not been evaluated in a prospective manner. With the aid of a dissecting microscope, we prospectively examined 47 lung specimens resected during the past 4 years and submitted with the clinical impression of ELS (n=11), ILS (n=11), CCAM (n=20), LE (n=4), and airway-esophageal communication (n=1). Most lesions were detected by prenatal ultrasound and were resected during infancy. The clinical impression and pathologic findings were compared. Pathologic examination revealed atresia of a lobar, segmental, or subsegmental bronchus in 100% of ELS, 82% of ILS, 70% of CCAM, and 50% of LE (those clinically recognized to have BA or minor CCAM) cases. Parenchymal maldevelopment that characterizes CCAM was present in 100% of CCAM cases (as expected by definition) as well as in 91% of ELS, 91% of ILS, and 50% of LE (those with BA) cases. Bronchial atresia is present in all ELS, most ILS and CCAM, and some LE cases, and its detection is greatly enhanced with the dissecting microscope. Bronchial atresia and CCAM nearly always coexist. It may be that both have the same etiopathogenesis with anatomic differences accounted for by aberrant genetic programs or other insults, perhaps modified by time of onset or duration.
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Lantuejoul S, Ferretti GR, Goldstraw P, Hansell DM, Brambilla E, Nicholson AG. Metastases from bronchioloalveolar carcinomas associated with long-standing type 1 congenital cystic adenomatoid malformations. A report of two cases. Histopathology 2006; 48:204-6. [PMID: 16405673 DOI: 10.1111/j.1365-2559.2005.02206.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Pathak D, Sarin YK. Unusual congenital cystic adenomatoid malformation of the lung: a diagnostic dilemma. Indian Pediatr 2005; 42:1255-6. [PMID: 16424571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
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46
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Pai S, Eng HL, Lee SY, Hsiao CC, Huang WT, Huang SC. Rhabdomyosarcoma arising within congenital cystic adenomatoid malformation. Pediatr Blood Cancer 2005; 45:841-5. [PMID: 16007610 DOI: 10.1002/pbc.20481] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Rhabdomyosarcoma arising within a congenital cystic adenomatoid malformation (CCAM) is an unusual entity. The patient underwent a lobectomy of his right lower lobe of lung due to a CCAM at the age of two. One year later, he developed a solid embryonal rhabdomyosarcoma at the same location. He received 1-year period chemotherapy and when the tumor reduced to a resectable size, surgical excision was done. The tumor cells appeared more differentiated after chemotherapy. The patient remains disease free to date, 16 months after surgery.
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Harada K, Noguchi T, Miura T, Kawano Y, Kashima K, Kawahara K. Successful treatment of an adult patient with pulmonary abscess secondary to congenital cystic adenomatoid malformation. ACTA ACUST UNITED AC 2005; 53:580-2. [PMID: 16279593 DOI: 10.1007/s11748-005-0073-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We report a case of a 29 year old male who at age 25, developed a pulmonary abscess in the left lower lobe. A left lower lobectomy was performed following two recurrences on antibiotic treatment. The result of histopathological examination confirmed congenital cystic adenomatoid malformation (CCAM), a congenital disease characterized by multiple cysts resulting from adenomatous hyperplasia of the bronchial epithelia. In many cases, respiratory distress occurs during the neonatal period, and in about 80-85% of patients, CCAM is diagnosed before the age of two years due to respiratory infection. CCAM which was diagnosed in adulthood is very rare.
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48
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Parikh D, Samuel M. Pulmonary stabilisation followed by delayed surgery results in favourable outcome in congenital cystic lung lesions with pulmonary hypertension. Eur J Cardiothorac Surg 2005; 28:607-10. [PMID: 16125963 DOI: 10.1016/j.ejcts.2005.06.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2005] [Revised: 05/06/2005] [Accepted: 06/29/2005] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Congenital cystic lung lesions associated with fetal hydrops and polyhydramnios are rare, and reported to have greater than 50% mortality, can this be reversed? To propose a period of pulmonary stabilisation and delayed surgery for neonates with congenital cystic lung lesions and pulmonary hypertension. RESULTS Four neonates with antenatal diagnosed congenital cystic lung lesions with associated fetal hydrops and maternal polyhydramnios, presented with pulmonary hypertension due to lung hypoplasia. Contrast spiral computerised tomography scan was diagnostic. Three had congenital cystic adenomatoid malformation and one extra-lobar pulmonary sequestration with anomalous blood supply from the abdominal aorta. All four were pre-operatively ventilated for 9.8+/-0.9 days on conventional mechanical ventilators. Definitive surgery was performed at 10.8+/-0.8 days following stabilisation of lung function (preductal PO(2) of greater than 60torr with a SaO(2) of 90-100%) and resolution of pulmonary hypertension with absence of persistent fetal circulation on echocardiography. Optimal timing of delayed surgery was in the range of 216-360h. All four are thriving with absent respiratory complications. CONCLUSION Delayed surgery following pulmonary stabilisation results in favourable outcome.
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Asabe K, Oka Y, Shirakusa T. Fetal case of congenital cystic adenomatoid malformation of the lung: fetal therapy and a review of the published reports in Japan. Congenit Anom (Kyoto) 2005; 45:96-101. [PMID: 16131368 DOI: 10.1111/j.1741-4520.2005.00075.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We herein report a case of type I congenital cystic adenomatoid malformation of the lung (CCAML) with non-immune hydrops fetalis (NIHF), a mediastinal shift and polyhydramnios diagnosed at 24 weeks' gestation by ultrasonography. The fetus was treated with a cyst-amniotic shunt at 29 weeks' gestation. Following a postnatal whole resection of the right lung, postpneumonectomy syndrome appeared and, as a result, the infant died 13 months after delivery due to respiratory failure. Only 19 cases demonstrating CCAML associated with NIHF have been reported previously in Japan. Four cases showed a spontaneous resolution of NIHF, while 5 cases with type I CCAML, which all underwent fetal intervention, demonstrated an excellent outcome.
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Doladzas T, Arvelakis A, Karavokyros IG, Gougoudi E, Pikoulis E, Patsouris E, Michail PO. Primary rhabdomyosarcoma of the lung arising over cystic pulmonary adenomatoid malformation. Pediatr Hematol Oncol 2005; 22:525-9. [PMID: 16169819 DOI: 10.1080/08880010591002396] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The authors report the case of a 2-year-old girl with pulmonary cystic adenomatoid malformation type II who presented with a mass on the lower lobe of the left lung. Resection and histological examination revealed pleomorphic rhabdomyosarcoma. Chemotherapy and radiotherapy followed the operation and the girl is alive and in perfect condition 10 years after the operation. The literature on primary rhabdomyosarcoma of the lung in children is reviewed.
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