1
|
Yang X, Chen Y, Yang Y, Li S, Mi P, Jing N. The molecular and cellular choreography of early mammalian lung development. MEDICAL REVIEW (2021) 2024; 4:192-206. [PMID: 38919401 PMCID: PMC11195428 DOI: 10.1515/mr-2023-0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/08/2024] [Indexed: 06/27/2024]
Abstract
Mammalian lung development starts from a specific cluster of endodermal cells situated within the ventral foregut region. With the orchestrating of delicate choreography of transcription factors, signaling pathways, and cell-cell communications, the endodermal diverticulum extends into the surrounding mesenchyme, and builds the cellular and structural basis of the complex respiratory system. This review provides a comprehensive overview of the current molecular insights of mammalian lung development, with a particular focus on the early stage of lung cell fate differentiation and spatial patterning. Furthermore, we explore the implications of several congenital respiratory diseases and the relevance to early organogenesis. Finally, we summarize the unprecedented knowledge concerning lung cell compositions, regulatory networks as well as the promising prospect for gaining an unbiased understanding of lung development and lung malformations through state-of-the-art single-cell omics.
Collapse
Affiliation(s)
- Xianfa Yang
- Guangzhou National Laboratory, Guangzhou, Guangdong Province, China
| | - Yingying Chen
- Guangzhou National Laboratory, Guangzhou, Guangdong Province, China
| | - Yun Yang
- Guangzhou National Laboratory, Guangzhou, Guangdong Province, China
- Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Shiting Li
- Guangzhou National Laboratory, Guangzhou, Guangdong Province, China
- Institute of Biomedical Research, Yunnan University, Kunming, Yunnan Province, China
| | - Panpan Mi
- Guangzhou National Laboratory, Guangzhou, Guangdong Province, China
- Department of Histology and Embryology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Naihe Jing
- Guangzhou National Laboratory, Guangzhou, Guangdong Province, China
| |
Collapse
|
2
|
Devalla L, Ghewade B, Jadhav U, Wagh P, Alone VD. Late Presentation of Pulmonary Aplasia in Adulthood: A Report of a Rare Case. Cureus 2024; 16:e62647. [PMID: 39036198 PMCID: PMC11258940 DOI: 10.7759/cureus.62647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 06/18/2024] [Indexed: 07/23/2024] Open
Abstract
Aplasia of the lung is an uncommon congenital anomaly that can resemble several common illnesses radiologically and presents as an opaque hemithorax with ipsilateral displacement of the mediastinum. This case scenario involves a young woman who has been experiencing recurrent pulmonary tract infections and worsening dyspnea since childhood, presenting as pneumonic consolidation on a chest X-ray. The case explores the importance of lung scans, CT pulmonary angiography, and bronchoscopy to elicit the absence of lung parenchyma on one side.
Collapse
Affiliation(s)
- Lokesh Devalla
- Respiratory Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Babaji Ghewade
- Respiratory Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Ulhas Jadhav
- Respiratory Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Pankaj Wagh
- Respiratory Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Vivek D Alone
- Respiratory Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| |
Collapse
|
3
|
Gunathilaka N, Bandara H, Dissanayaka T, Sathiyamoorthy S, Gunasinghe W, Kularatne S. Unilateral pulmonary agenesis with ipsilateral facial congenital anomalies in an adult with obstructive airway disease. Respirol Case Rep 2024; 12:e01332. [PMID: 38559903 PMCID: PMC10981864 DOI: 10.1002/rcr2.1332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 03/17/2024] [Indexed: 04/04/2024] Open
Abstract
Pulmonary agenesis is a rare congenital anomaly which can be isolated or co-exist with other developmental defects. Boyden et al has described three degrees of mal development of lung which include agenesis, hypoplasia and aplasia. Almost all the reported cases are in paediatric age group patients while, adults with pulmonary developmental abnormalities are sparsely documented in the literature. Interestingly, adult with coexisting hemifacial anomaly and pulmonary agenesis has not been reported in the medical literature. Here, we describe a middle-aged female who initially presented with bronchial asthma and her chest radiography showed absent left lung which was later confirmed with enhanced CT imaging. Furthermore, she had ipsilateral hemi facial microsomia, microtia, facial nerve palsy and mixed sensory loss, left side large café au lait patch, splenicule and hemangioma in segment V/VI of the liver.
Collapse
Affiliation(s)
- Nilanthi Gunathilaka
- Pulmonology DepartmentNational Hospital for Respiratory DiseasesWelisaraSri Lanka
| | - Harshana Bandara
- Pulmonology DepartmentNational Hospital for Respiratory DiseasesWelisaraSri Lanka
- North West Lung CentreWythenshawe HospitalManchesterUnited Kingdom
| | - Tharindi Dissanayaka
- Pulmonology DepartmentNational Hospital for Respiratory DiseasesWelisaraSri Lanka
| | | | - Wathsala Gunasinghe
- Pulmonology DepartmentNational Hospital for Respiratory DiseasesWelisaraSri Lanka
| | - Saman Kularatne
- Pulmonology DepartmentNational Hospital for Respiratory DiseasesWelisaraSri Lanka
| |
Collapse
|
4
|
Upadhya P, Arpitha A, Sivaselvi C, Papa D, Vignesh K. A Rare Case of Lung Hypoplasia, Cardiac Anomalies and Ovarian Tumour in a Patient with Mayer-Rokitansky-Küster-Hauser Syndrome. Sultan Qaboos Univ Med J 2023; 23:556-559. [PMID: 38090232 PMCID: PMC10712378 DOI: 10.18295/squmj.1.2023.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/14/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
Hypoplasia of the lung is an uncommon congenital abnormality of the respiratory system in contrast to pulmonary agenesis. Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is the congenital absence of the upper two-thirds of the vagina and uterus with normal secondary sexual characteristics, ovary and normal karyotype. We report a 31-year-old female patient who presented in 2022 with cough with expectoration, left-side chest pain and breathlessness for 4 years to tertiary hospital, Puducherry, India. She was evaluated for amenorrhoea and diagnosed as MRKH syndrome and the patient underwent right-side oophorectomy for right ovarian torsion with a tumour. Computed tomography pulmonary angiogram and fiberoptic endoscopy were suggestive of left lung hypoplasia and the patient was advised symptomatic treatment for lung hypoplasia and planned for vaginoplasty for which she refused.
Collapse
Affiliation(s)
- Pratap Upadhya
- Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
| | - A. Arpitha
- Department of Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
| | - C. Sivaselvi
- Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
| | - Dasari Papa
- Department of Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
| | - K. Vignesh
- Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
| |
Collapse
|
5
|
Alwan A, Mohammoud S, Assefa AZ. Incidental pulmonary agenesis with multiple associated anomalies: A case report. Radiol Case Rep 2023; 18:3724-3728. [PMID: 37636541 PMCID: PMC10447928 DOI: 10.1016/j.radcr.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 07/29/2023] [Accepted: 08/01/2023] [Indexed: 08/29/2023] Open
Abstract
Pulmonary agenesis is an uncommon congenital abnormality of the lungs that occurs either in isolation or in association with other anomalies in several organ systems. Right sided pulmonary agenesis is reported to have a worse prognosis owing to the more severe mediastinal shift and resultant compression of mediastinal structures. We present a case of right-side pulmonary agenesis with multiple associated anomalies found incidentally in a 19-year-old female patient.
Collapse
Affiliation(s)
- Amir Alwan
- Department of Clinical Radiology, College of Health Sciences, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Suad Mohammoud
- Department of Clinical Radiology, College of Health Sciences, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abenezer Z. Assefa
- Department of Clinical Radiology, College of Health Sciences, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
6
|
Lu L, Hu S, Wang G, Jin R, Guan R, Cui F, Qu Z, Liu D. Congenital pulmonary hypoplasia combined with congenital cardiac disease and ectopic kidney: a case report. ASIAN BIOMED 2023; 17:244-248. [PMID: 37899760 PMCID: PMC10602632 DOI: 10.2478/abm-2023-0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Background Congenital pulmonary hypoplasia (CPH) is a rare pulmonary disease featured by incomplete development of pulmonary tissues. Its diagnosis is still a challenge as patients are usually misdiagnosed as atelectasis. Case presentation A female neonate was admitted to our hospital due to post-birth jaundice for 12 hrs. Physical examination showed accelerated breathing. There was no respiratory sound in the left lung. Chest film indicated decline of lucency in the left lung. Chest CT scan indicated absence of left lung and primary bronchus of the left lung. The boundary between left mediastinum was not clearly displayed. Three-dimensional CT scan indicated absence of left lung and left principal bronchus. Cardiac ultrasonography confirmed congenital heart disease. She showed ectopic kidney. Finally, she was diagnosed with CPH concurrent with congenital heart disease and ectopic kidney. Conclusions On 17-month follow-up visit, the patient is still survived, but she presents with obstruction in ventilation function.
Collapse
Affiliation(s)
- Ling Lu
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao266003, China
| | - Sujuan Hu
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao266003, China
| | - Gaoyan Wang
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao266003, China
| | - Rong Jin
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao266003, China
| | - Renzheng Guan
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao266003, China
| | - Fengjing Cui
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao266003, China
| | - Zhenghai Qu
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao266003, China
| | - Dongyun Liu
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao266003, China
| |
Collapse
|
7
|
Guo H, Xin Z, Duan G, Zhang X. Case report involving hypoplasia of the middle and lower lobe of the right lung. Asian J Surg 2023:S1015-9584(23)00106-9. [PMID: 36737330 DOI: 10.1016/j.asjsur.2023.01.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 01/10/2023] [Indexed: 02/05/2023] Open
Affiliation(s)
- Haoxin Guo
- Graduate School, Hebei Medical University, Shijiazhuang, 050017, People's Republic of China; Department of Thoracic Surgery, Hebei General Hospital, Shijiazhuang, 050057, People's Republic of China
| | - Zhifei Xin
- Department of Thoracic Surgery, Hebei General Hospital, Shijiazhuang, 050057, People's Republic of China
| | - Guochen Duan
- Department of Thoracic Surgery, Children's Hospital of Hebei Province, Shijiazhuang, 050000, People's Republic of China.
| | - Xiaopeng Zhang
- Department of Thoracic Surgery, Hebei General Hospital, Shijiazhuang, 050057, People's Republic of China
| |
Collapse
|
8
|
Kissou SA, Adjaba SBW, Tamini J, Traore H. Unilateral Pulmonary Agenesis about a Case Revealed by an Acute Respiratory Infection in a Young Infant. Case Rep Pediatr 2023; 2023:8110952. [PMID: 36937501 PMCID: PMC10019967 DOI: 10.1155/2023/8110952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/27/2022] [Accepted: 03/04/2023] [Indexed: 03/11/2023] Open
Abstract
Pulmonary agenesis is a rare congenital anomaly of unknown cause, consisting of a complete absence of the lung parenchyma, bronchi, and vascularization. It may or not be associated with other malformations. The authors report a case of right pulmonary agenesis diagnosed in a four-month-old infant who had no previous pathological history and was growing well. The circumstance of discovery was respiratory distress during an infectious episode. The diagnosis was suspected on a standard chest X-ray and confirmed on a chest CT scan. There are no other associated defects. The evolution was good after antibiotic therapy. While bilateral pulmonary agenesis is incompatible with life, the unilateral form may remain unrecognized until adulthood. The prognosis depends mainly on the importance of the associated malformations.
Collapse
Affiliation(s)
- S. Aimée Kissou
- 1Department of Pediatrics, CHU Sourô Sanou (CHUSS), BP 676, Bobo-Dioulasso, Burkina Faso
- 2Higher Institute of Health Sciences (INSSA), Nazi BONI University (UNB), Bobo-Dioulasso, Burkina Faso
| | | | - Jacqueline Tamini
- 1Department of Pediatrics, CHU Sourô Sanou (CHUSS), BP 676, Bobo-Dioulasso, Burkina Faso
| | - Hélène Traore
- 1Department of Pediatrics, CHU Sourô Sanou (CHUSS), BP 676, Bobo-Dioulasso, Burkina Faso
| |
Collapse
|
9
|
Qiu M, Lin DR. Buccal carcinoma associated with adult congenital pulmonary hypoplasia: A case report and literature review. Medicine (Baltimore) 2022; 101:e32142. [PMID: 36482601 PMCID: PMC9726420 DOI: 10.1097/md.0000000000032142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
RATIONALE Congenital pulmonary hypoplasia is a relatively rare lung malformation. The disease is usually identified in the neonatal period or early childhood. Most affected patients die of respiratory insufficiency after birth. Mild congenital dysplasia is asymptomatic, while moderate congenital dysplasia manifests as respiratory distress or does not become evident until adulthood. Cases of congenital pulmonary hypoplasia in adults are rare, especially in combination with malignant tumors. PATIENT CONCERNS We report the case of a 64-year-old man with buccal carcinoma who was accidentally found to have hypoplasia of the left lung during treatment. DIAGNOSES After chest computed tomography and chest radiograph, the diagnosis of adult congenital pulmonary hypoplasia was confirmed. INTERVENTIONS Since the patient had a history of bronchiectasis for more than 30 years and only had 1 healthy lung, the cardiopulmonary compensatory function was poor and the patient could not tolerate surgery, he was given radiotherapy and chemotherapy. OUTCOMES Radiotherapy and chemotherapy were successfully completed, and within the patient's tolerance, there was no serious adverse reaction of respiratory system. CONCLUSION Congenital pulmonary hypoplasia's diagnosis is challenging in adults because the condition can easily be mistaken for a more common disease. However, early diagnosis is very important to enable prompt therapy and ensure proper follow-up to detect and treat complications such as pulmonary infection and pulmonary hypertension in a timely manner.
Collapse
Affiliation(s)
- Miao Qiu
- Department of Tumor Radiotherapy, Shaoxing Second Hospital, Shaoxing, China
- *Correspondence: Miao Qiu, Department of Tumor Radiotherapy, Shaoxing Second Hospital, Shaoxing, Zhejiang 312000, China (e-mail: )
| | - De-Rong Lin
- Department of Tumor Radiotherapy, Shaoxing Second Hospital, Shaoxing, China
| |
Collapse
|
10
|
Panduranga S, V H, Mehta RM. An unique case of isolated right upper lobe lung agenesis with abnormal middle lobe segmentation. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2022. [DOI: 10.1186/s43168-022-00146-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Isolated right upper lobe pulmonary agenesis is a highly uncommon congenital anomaly, usually detected at adulthood when the patient is evaluated for an incidental abnormal chest radiograph. Chest radiography findings are non-specific. Chest computed tomography with pulmonary angiography is the modality of choice for diagnosing pulmonary agenesis.
Case presentation
We describe a case of isolated right upper lobe agenesis in a young man who presented with mild shortness of breath and an abnormal chest radiograph. High-resolution computed tomography chest showed right upper lobe pulmonary agenesis which was initially erroneously diagnosed as right lower lobe collapse on chest X-ray. Abnormal segmentation of the middle lobe was also seen which has not been described earlier according to our literature search.
Conclusions
There should be a high index of suspicion for congenital anomalies on chest X-ray to recommend further imaging studies. This case highlights the importance of computed tomography with pulmonary angiography to adequately assess and characterize the congenital lung anomalies.
Collapse
|
11
|
Fukuoka S, Yamamura K, Nagata H, Toyomura D, Nagatomo Y, Eguchi Y, Uike K, Hirata Y, Inoue H, Ochiai M, Ohga S. Clinical outcomes of pulmonary agenesis: A systematic review of the literature. Pediatr Pulmonol 2022; 57:3060-3068. [PMID: 36069476 DOI: 10.1002/ppul.26135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 08/01/2022] [Accepted: 08/27/2022] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Pulmonary agenesis is a complete absence of the pulmonary parenchyma, airways, and vasculature unilaterally or bilaterally. Although bilateral cases are lethal, the outcome of unilateral cases remains not well described. We performed a comprehensive literature review to assess the clinical features of pulmonary agenesis. METHODS Four database sources were searched on October 10, 2021 and two cases were included from our institution. Studies related to the clinical impact of comorbidity and intervention on the survival outcome in pulmonary agenesis were included for full-text review. RESULTS We identified 259 patients-with right-sided (59%), left-sided (34%), and bilateral agenesis (7%)-among 195 articles and our two cases. Additional anomalies included cardiovascular (40%), skeletal (30%), gastrointestinal (20%), tracheal (20%: all stenoses), and genitourinary (14%) anomalies. Fifty-seven (24%) individuals in unilateral pulmonary agenesis had isolated disease. Outcomes related to survival were not uniformly reported, but the 2-year overall survival rate of unilateral agenesis was 62% and no subsequent death was reported until 13 years of age. The right-sided agenesis was more frequently associated with tracheal stenosis (27% vs. 11%, p = 0.003) than the left-sided disease. A multivariable analysis indicated that tracheal stenosis (hazard ratio [HR]: 2.2, 95% confidence interval [CI]: 1.3-4.1, p = 0.003) and gastrointestinal anomalies (HR: 2.0, 95% CI: 1.1-3.3, p = 0.010) were prognostic factors for mortality. CONCLUSIONS The poor prognostic factors were tracheal stenosis, right agenesis, and gastrointestinal anomalies. Treatment for these comorbidities is a key point for improving the survival of unilateral pulmonary agenesis.
Collapse
Affiliation(s)
- Shoji Fukuoka
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kenichiro Yamamura
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hazumu Nagata
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Daisuke Toyomura
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yusaku Nagatomo
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshimi Eguchi
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kiyoshi Uike
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuichiro Hirata
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hirosuke Inoue
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masayuki Ochiai
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shouichi Ohga
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| |
Collapse
|
12
|
Anatomical variations in lung fissures leading to supernumerary lobes in the lungs. TRANSLATIONAL RESEARCH IN ANATOMY 2022. [DOI: 10.1016/j.tria.2022.100209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
13
|
Subramanian S, Bapat M. Management of child with unilateral lung hypoplasia for ophthalmic surgery. J Anaesthesiol Clin Pharmacol 2022; 38:510-511. [PMID: 36505217 PMCID: PMC9728425 DOI: 10.4103/joacp.joacp_297_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/30/2021] [Accepted: 06/03/2021] [Indexed: 11/07/2022] Open
Affiliation(s)
- Shalini Subramanian
- Department of Anaesthesia, Narayana Nethralaya, Narayana Health City, Bommasandra, Bangalore, Karnataka, India,Address for correspondence: Dr. Shalini Subramanian, Department of Anaesthesia, Narayana Nethralaya, NN-2, Narayana Health City, Bommasandra, Bangalore - 560 099, Karnataka, India. E-mail:
| | - Medha Bapat
- Department of Anaesthesia, Narayana Nethralaya, Narayana Health City, Bommasandra, Bangalore, Karnataka, India
| |
Collapse
|
14
|
Luo J, He Y. Right Upper Lobe Pulmonary Hypoplasia. Radiology 2021; 302:26. [PMID: 34636632 DOI: 10.1148/radiol.2021211523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jing Luo
- From the Department of Radiology, Hunan Provincial People's Hospital (First Affiliated Hospital of Hunan Normal University), No. 61 Jiefang West Road, Changsha, Hunan, China
| | - Yaqiong He
- From the Department of Radiology, Hunan Provincial People's Hospital (First Affiliated Hospital of Hunan Normal University), No. 61 Jiefang West Road, Changsha, Hunan, China
| |
Collapse
|
15
|
Raja Mamat TA, Sayuti KA, Nadarajan C, Mohd Zain MR. Unilateral opaque chest radiograph in paediatrics: A case series. SA J Radiol 2021; 25:2164. [PMID: 34522433 PMCID: PMC8424740 DOI: 10.4102/sajr.v25i1.2164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/11/2021] [Indexed: 11/11/2022] Open
Abstract
Pulmonary underdevelopment is a rare congenital disease which manifests as persistent hemithorax opacification at chest radiography. We present three patients with different types of pulmonary underdevelopment, their imaging features and associated anomalies. Case 1 is a premature neonate with persistent respiratory distress. Further imaging confirmed right pulmonary hypoplasia, associated with a patent foramen ovale, patent ductus arteriosus and vertebral anomalies. Case 2 is a 6-year-old child with corrected anorectal malformation, and recurrent pneumonia. Further imaging confirmed left pulmonary aplasia, associated with an aberrant right subclavian artery and vertebral anomaly. Case 3 is a full term neonate who developed excessive drooling of saliva and respiratory distress. Further imaging confirmed right pulmonary agenesis, associated with an atrial septal defect, patent ductus arteriosus and tracheo-oesophageal fistula. Pulmonary underdevelopment is classified into three types: hypoplasia, aplasia and agenesis. The majority of them have associated anomalies. This condition should be considered a differential diagnosis in paediatric patients with an opaque hemithorax on chest radiography.
Collapse
Affiliation(s)
- Tengku A Raja Mamat
- Department of Radiology, School of Medical Sciences, University Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Department of Radiology, Hospital University Sains Malaysia, Kubang Keria, Kelantan, Malaysia
| | - Khairil A Sayuti
- Department of Radiology, School of Medical Sciences, University Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Department of Radiology, Hospital University Sains Malaysia, Kubang Keria, Kelantan, Malaysia
| | - Chandran Nadarajan
- Department of Radiology, School of Medical Sciences, University Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Department of Radiology, Hospital University Sains Malaysia, Kubang Keria, Kelantan, Malaysia
| | - Mohd R Mohd Zain
- Department of Paediatrics, School of Medical Sciences, University Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Department of Paediatrics, Hospital University Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| |
Collapse
|
16
|
Congenital isolated unilateral agenesis of pulmonary arteries in adults: case series and review. Indian J Thorac Cardiovasc Surg 2020; 37:144-154. [PMID: 33584030 DOI: 10.1007/s12055-020-01032-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/30/2020] [Accepted: 08/03/2020] [Indexed: 10/23/2022] Open
Abstract
Congenital, isolated unilateral agenesis of pulmonary arteries (UAPA) has a bimodal clinical presentation. It is either diagnosed in early infancy or during adulthood. Early diagnosis and timely surgical correction at infancy prevent the development of irreversible pulmonary hypertension and enable prolonged survival. Though surgical intervention is a conclusive method of treatment, its outcome depends upon the reversibility of pulmonary hypertension and the adequacy of the pulmonary artery dimension. Adults with UAPA can be asymptomatic (diagnosed incidentally) or symptomatic. They may present clinically with myriads of symptoms like exertional dyspnea, recurrent lung infection, hemoptysis, and atypical chest pain. For cases where definitive surgical treatment is not feasible, interventional and medical management should be carried out as part of palliative therapy. A retrospective analysis of 22 cases of UAPA in adults published in the literature from the years 2017-2020 are presented here, along with our institutional case.
Collapse
|
17
|
An adult patient presenting with right unilateral pulmonary agenesis: a case report and literature review. Surg Radiol Anat 2020; 42:1299-1301. [PMID: 32266442 DOI: 10.1007/s00276-020-02467-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 03/31/2020] [Indexed: 10/24/2022]
Abstract
Pulmonary agenesis is a rare developmental defect in which there is complete absence of one or both lungs. Although the diagnosis is often made during childhood, asymptomatic patients can be diagnosed later due to the absence of comorbid anomalies. Chest radiography with an elevation of the hemidiaphragm and heart shifted to the right should make physicians suspicious for right lung agenesis. Here, we present a case report of a 53-year-old male with unilateral pulmonary agenesis of right lung found incidentally. He had a complaint of dyspnea. The respiratory system examination revealed no breathing sounds on the right side with normal breathing sounds on the left side. A posterior anterior chest radiograph revealed homogenous opacity of the middle and lower radiological lung zone with elevation of the right hemidiaphragm. In addition, the trachea and heart were shifted to the right side. Contrast-enhanced multidetector computed tomography revealed the absence of the right lung parenchyma, right main bronchus, and right main pulmonary artery and vein. The left lung had normal pulmonary vasculature, was hyperinflated, and partially extended to the right hemithorax. A pulmonary conus was formed by only the left pulmonary artery. No congenital anomalies were detected.
Collapse
|
18
|
Unilateral pulmonary aplasia and congenital diaphragmatic hernia associated with tetralogy of Fallot: a rare trifecta. Cardiol Young 2020; 30:121-122. [PMID: 31915096 DOI: 10.1017/s1047951119003251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We present a case of a 7-month-old boy with tetralogy of Fallot associated with unilateral pulmonary aplasia and herniation of the liver and small bowel loops in the right hemithorax.
Collapse
|
19
|
Investigation of displaced bronchi using multidetector computed tomography: associated abnormalities of lung lobulations, pulmonary arteries and veins. Gen Thorac Cardiovasc Surg 2019; 68:342-349. [DOI: 10.1007/s11748-019-01223-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 09/29/2019] [Indexed: 12/11/2022]
|
20
|
Dextrocardia with pulmonary hypoplasia: an unusual cause of unilateral lung white-out. BMJ Case Rep 2019; 12:12/5/e229413. [DOI: 10.1136/bcr-2019-229413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Pulmonary agenesis is a rare developmental disorder with many syndromic associations. Type III agenesis presents with variable amounts of bronchial tree, pulmonary parenchyma and supporting vasculature. It is also reported to be associated with dextrocardia due to shifting of the heart to occupy the space left by the underdeveloped lung, which occurs as early as the fourth week of gestation. Right lung agenesis is considered rarer than its left-sided counterpart and also has a poorer prognosis due to increased chances of respiratory infections. We report a case of isolated right-sided lung hypoplasia with dextrocardia without situs inversus or heterotaxy.
Collapse
|
21
|
Sadiqi J, Hamidi H. CT features of lung agenesis - a case series (6 cases). BMC Med Imaging 2018; 18:37. [PMID: 30376819 PMCID: PMC6208179 DOI: 10.1186/s12880-018-0281-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 10/17/2018] [Indexed: 11/18/2022] Open
Abstract
Back ground Lung agenesis is a rare congenital anomaly. The main etiology of the disease is unknown whereas genetic, iatrogenic and viral factors as well as vitamin A deficiency during early pregnancy may result in developmental failure of primitive lung bud causing unilateral pulmonary agenesis. Affected patients usually present with variable respiratory symptoms and recurrent chest infection at any age. Plain film demonstrates opaque unilateral lung while chest CT scan can definitely diagnosis the disease. The anomaly has three types. Type I is pulmonary agenesis, type II is called pulmonary aplasia and type III is pulmonary hypoplasia. Cases’ presentation Six patients with main complaint of dyspnea underwent contrast enhanced chest CT in radiology department of French Medical Institute for Mothers and children, Kabul and were diagnosed lung agenesis. Three patients were categorized as type II pulmonary agenesis (aplasia). Two patients, three months old boy and a seven year- old girl demonstrated right lung aplasia. Another patient boy of eighteen years old presented with left lung aplasia. Two boys of four and seven months of age were classified as type I pulmonary agenesis (agenesis). A boy of one year old was diagnosed pulmonary agenesis type III, right lung hypoplasia. Conclusion Six patients were diagnosed with pulmonary agenesis by Chest CT scan. The clinicians should consider possibility of congenital pulmonary agenesis in dyspneic patients with opaque unilateral hemithorax in plain film.
Collapse
Affiliation(s)
- Jamshid Sadiqi
- Department of Radiology, French Medical Institute for Mothers & Children (FMIC), behind Kabul Medical University, Jamal mina, P.O. Box: 472, Kabul, Afghanistan.
| | - Hidayatullah Hamidi
- Department of Radiology, French Medical Institute for Mothers & Children (FMIC), behind Kabul Medical University, Jamal mina, P.O. Box: 472, Kabul, Afghanistan
| |
Collapse
|
22
|
Lin S, Guan W, LaZhou C, Shi Y. Left lung hypoplasia with a right tuberculous pleural effusion after childbirth: A case report. Medicine (Baltimore) 2018; 97:e10868. [PMID: 29794790 PMCID: PMC6393107 DOI: 10.1097/md.0000000000010868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Unilateral hypoplasia of the lung is a rare congenital condition, the mechanism of which is poorly understood. Primary pulmonary hypoplasia occurring in an adult is extremely rare and we present what is probably the first case of a link to a tuberculous pleural effusion in a young woman after childbirth. PATIENT CONCERNS Herein, we describe a 31-year-old woman with left lung hypoplasia, and she not only survived to adulthood without problems, but was able to deliver a baby in natural labor. DIAGNOSES Left lung hypoplasia, right tuberculous pleural effusion. INTERVENTIONS We initiated an anti-tuberculosis treatment for this patient with dose adjustments to her weight of isoniazid (0.3 g/day), rifampicin (0.45 g/day), pyrazinamide (1.5 g/day), and ethambutol (0.75 g/day) for 2 months then isoniazid and rifampicin for another 4 months. OUTCOMES Ten days later after beginning therapy, she became afebrile and the pleural effusion resolved. No recurrence was observed during a 6-month follow-up period. LESSONS In clinical practice, if one sees a chest x-ray revealing complete or incomplete opacification of a hemithorax with volume loss and history of repeated respiratory infections, one should consider the possibility of unilateral pulmonary hypoplasia. In such cases, regular close follow-up is important to minimize infections and to prevent development of cor pulmonale or respiratory failure.
Collapse
|
23
|
Affiliation(s)
- Sunil Vyas
- Department of Tuberculosis and Respiratory Diseases, Dr. S.N. Medical College, Jodhpur, Rajasthan, India
| | - Theres Mathew
- Department of Tuberculosis and Respiratory Diseases, Dr. S.N. Medical College, Jodhpur, Rajasthan, India
| | - Manish Advani
- Department of Tuberculosis and Respiratory Diseases, Dr. S.N. Medical College, Jodhpur, Rajasthan, India
| | - Devesh Meena
- Department of Tuberculosis and Respiratory Diseases, Dr. S.N. Medical College, Jodhpur, Rajasthan, India
| |
Collapse
|
24
|
Kaya O, Gulek B, Yilmaz C, Soker G, Esen K, Akin MA, Dilek O. Adult presentation of symptomatic left lung agenesis. Radiol Case Rep 2017; 12:25-28. [PMID: 28228871 PMCID: PMC5310534 DOI: 10.1016/j.radcr.2016.11.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 11/22/2016] [Indexed: 11/03/2022] Open
Abstract
Pulmonary agenesis is a rarely encountered congenital anomaly, and its average prevalence is about 1 in 100,000 births. Anomalies of the cardiovascular, musculoskeletal, gastrointestinal, or genitourinary systems may accompany in nearly half of the cases. The diagnosis of pulmonary agenesis is usually made during childhood, but the diagnosis may be delayed until adulthood in case of an absence of comorbid anomalies . Herein, we present a case of pulmonary agenesis that was diagnosed during adulthood.
Collapse
Affiliation(s)
- Omer Kaya
- Department of Radiology, Adana Numune Teaching and Research Hospital, Ege Bagatur Boulevard, 01240, Yuregir, Adana, Turkey
| | - Bozkurt Gulek
- Department of Radiology, Adana Numune Teaching and Research Hospital, Ege Bagatur Boulevard, 01240, Yuregir, Adana, Turkey
| | - Cengiz Yilmaz
- Department of Radiology, Adana Numune Teaching and Research Hospital, Ege Bagatur Boulevard, 01240, Yuregir, Adana, Turkey
| | - Gokhan Soker
- Department of Radiology, Adana Numune Teaching and Research Hospital, Ege Bagatur Boulevard, 01240, Yuregir, Adana, Turkey
| | - Kaan Esen
- Department of Radiology, Faculty of Medicine, Mersin University, 34th Street, 33110, Yenisehir, Mersin, Turkey
| | - Mehmet Ali Akin
- Department of Radiology, Adana Numune Teaching and Research Hospital, Ege Bagatur Boulevard, 01240, Yuregir, Adana, Turkey
| | - Okan Dilek
- Department of Radiology, Adana Numune Teaching and Research Hospital, Ege Bagatur Boulevard, 01240, Yuregir, Adana, Turkey
| |
Collapse
|
25
|
Right Lung Agenesis with Tracheal Stenosis due to Complete Tracheal Rings and Postpneumonectomy Like Syndrome Treated with Tissue Expander Placement. Case Rep Pulmonol 2016; 2016:4397641. [PMID: 27882259 PMCID: PMC5108851 DOI: 10.1155/2016/4397641] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 10/04/2016] [Indexed: 11/18/2022] Open
Abstract
Congenital lung agenesis is an extremely rare condition with an estimated prevalence of 34 in 1,000,000 live births. It is often associated with other congenital malformations of the skeletal, cardiovascular, urogenital, and gastrointestinal systems. We discuss the case of a 5-month-old who presented with increasing stridor over 1 month. Imaging revealed right lung agenesis, complete dextromalposition of heart, and compression of distal trachea. An intrathoracic saline tissue expander was placed which marked improved distal tracheal stenosis. In patients who are symptomatic it becomes imperative to perform surgeries to increase survival as was the case in this patient.
Collapse
|
26
|
Kumar P, Tansir G, Sasmal G, Dixit J, Sahoo R. Left Pulmonary Agenesis with Right Lung Bronchiectasis in an Adult. J Clin Diagn Res 2016; 10:OD15-OD17. [PMID: 27790501 DOI: 10.7860/jcdr/2016/21623.8547] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 08/06/2016] [Indexed: 11/24/2022]
Abstract
Pulmonary agenesis is a rare congenital anomaly characterized by the absence of pulmonary parenchyma and vasculature. Bilateral pulmonary agenesis is incompatible with extrauterine life. Unilateral agenesis is often associated with other congenital cardiovascular, genitourinary and gastrointestinal malformations. Right lung agenesis is more frequently associated with congenital anomalies and has poor prognosis as compared to left lung agenesis. Diagnosis is often made in childhood but can be delayed, if the clinician is not aware about this entity. Chest radiograph in unilateral lung agenesis shows opaque hemithorax and these patients are often confused with other common causes of opaque hemithorax like collapse, pleural effusion and diaphragmatic hernia. We report a case of left lung agenesis with right lung bronchiectasis in a middle-aged adult who was treated for tuberculous pleural effusion and was referred to our institute for persistent symptoms despite treatment.
Collapse
Affiliation(s)
- Prabhat Kumar
- Senior Resident, Department of Medicine, PGIMER and Dr. Ram Manohar Lohia Hospital , New Delhi, India
| | - Ghazal Tansir
- Postgraduate Resident, Department of Medicine, PGIMER and Dr. Ram Manohar Lohia Hospital , New Delhi, India
| | - Gargi Sasmal
- Postgraduate Resident, Department of Medicine, PGIMER and Dr. Ram Manohar Lohia Hospital , New Delhi, India
| | - Juhi Dixit
- Postgraduate Resident, Department of Medicine, PGIMER and Dr. Ram Manohar Lohia Hospital , New Delhi, India
| | - Ratnakar Sahoo
- Professor, Department of Medicine, PGIMER and Dr. Ram Manohar Lohia Hospital , New Delhi, India
| |
Collapse
|
27
|
Mirchandani LV, Alam A, Iyer A, Kutty JT. Rare Case of Unilateral Hypoplasia of Lung with Associated Ventricular Mass in an Adult. J Clin Diagn Res 2016; 10:OD05-7. [PMID: 27630888 DOI: 10.7860/jcdr/2016/19591.8138] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 05/16/2016] [Indexed: 11/24/2022]
Abstract
Hypoplasia of the lung is a rare congenital condition which can be: a) primary i.e. no apparent cause is found; or b) secondary i.e. associated with other congenital anomalies that are implicated in its pathogenesis. These anomalies may involve the diaphragm, cardiovascular, central nervous, urogenital and musculoskeletal system. Patients usually present in neonatal, infancy or childhood period and very rarely in adulthood. Our patient was an adult having a unilateral hypoplastic lung associated with a ventricular mass and to our knowledge this rare combination has never been reported in the English literature; though there are reports of prenatal or newborns with hypoplastic lung and rhabdomyoma of ventricle who did not survive.
Collapse
Affiliation(s)
- Lavina Vishnu Mirchandani
- Associate Professor, Department of Pulmonary Medicine, Dr. D.Y. Patil University, College of Medicine , Nerul, Navi Mumbai, Maharashtra, India
| | - Azad Alam
- Resident, Department of Pulmonary Medicine, Dr. D.Y. Patil University, College of Medicine , Nerul, Navi Mumbai, Maharashtra, India
| | - Aparna Iyer
- Assistant Professor, Department of Pulmonary Medicine, Dr. D.Y. Patil University, College of Medicine , Nerul, Navi Mumbai, Maharashtra, India
| | - Jayalakshmi Thelapurath Kutty
- Professor and Head, Department of Pulmonary Medicine, Dr. D.Y. Patil University, College of Medicine , Nerul, Navi Mumbai, Maharashtra, India
| |
Collapse
|
28
|
Upadhyay H, Contreras J, Hashemi Z, Khokar A, Nangrani K, Arjomand F, Gerolemou L, Vasudevan V. Dyspnoea in a patient with unilateral lung agenesis. Postgrad Med J 2016; 92:744-746. [PMID: 27281815 DOI: 10.1136/postgradmedj-2016-134151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 05/18/2016] [Accepted: 05/24/2016] [Indexed: 11/04/2022]
Affiliation(s)
- Hinesh Upadhyay
- Department of Pulmonary and Critical Care Medicine, The Brooklyn Hospital Center, Brooklyn, New York, USA
| | - Jose Contreras
- Department of Pulmonary and Critical Care Medicine, The Brooklyn Hospital Center, Brooklyn, New York, USA
| | - Zary Hashemi
- Department of Pulmonary and Critical Care Medicine, The Brooklyn Hospital Center, Brooklyn, New York, USA
| | - Abid Khokar
- Department of Pulmonary and Critical Care Medicine, The Brooklyn Hospital Center, Brooklyn, New York, USA
| | - Kunal Nangrani
- Department of Pulmonary and Critical Care Medicine, The Brooklyn Hospital Center, Brooklyn, New York, USA
| | - Farhad Arjomand
- Department of Pulmonary and Critical Care Medicine, The Brooklyn Hospital Center, Brooklyn, New York, USA
| | - Louis Gerolemou
- Department of Pulmonary and Critical Care Medicine, The Brooklyn Hospital Center, Brooklyn, New York, USA
| | - Viswanath Vasudevan
- Department of Pulmonary and Critical Care Medicine, The Brooklyn Hospital Center, Brooklyn, New York, USA
| |
Collapse
|
29
|
Hentati A, Neifar C, Abid W, M'saad S. Left lung agenesis discovered by a spontaneous pneumothorax in a 20-year-old girl. Lung India 2016; 33:205-7. [PMID: 27051112 PMCID: PMC4797443 DOI: 10.4103/0970-2113.177443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Lung agenesis is a rare condition which prognosis widely depends on associated malformations. Clinical presentation is so variable and diagnosis is often made in childhood. Here, we present a case of a 20-year-old girl who was admitted because of a spontaneous pneumothorax. Explorations concluded at a left lung agenesis, a hyperinflated right lung crossing the midline with a corresponding pneumothorax. There was no malformation else. This congenital condition and treatment for this rare presentation are discussed in detail.
Collapse
Affiliation(s)
- Abdessalem Hentati
- Department of Thoracic Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Chawki Neifar
- Department of Thoracic Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Walid Abid
- Department of Thoracic Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Sameh M'saad
- Department of Thoracic Surgery, Respiratory Medicine, Hedi Chaker University Hospital, Sfax, Tunisia
| |
Collapse
|
30
|
Shivalingappa SS, Shetty SB. Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome with unilateral pulmonary agenesis-a rarity indeed: radiologic review. BJR Case Rep 2016; 2:20150157. [PMID: 30363603 PMCID: PMC6180887 DOI: 10.1259/bjrcr.20150157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 09/18/2015] [Accepted: 09/22/2015] [Indexed: 11/17/2022] Open
Abstract
Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome is a congenital condition characterized by agenesis of the uterus and vagina in females with normal ovaries and fallopian tubes, secondary sexual characteristics and 46XX karyotype. They present with primary amenorrhoea. Urinary anomalies, usually renal agenesis and rarely ectopia, occur. Skeletal abnormality can co-exist in about 10% of the patients. Simultaneous pulmonary hypoplasia has been reported very rarely in the literature. The normal external appearance of MRKH syndrome makes it difficult to diagnose until puberty. The purpose of this pictorial essay is to display the structural malformations of this rare disease. The presence of unilateral pulmonary agenesis is extremely rare. The use of invasive diagnostic laparoscopy and ionizing radiation, including intravenous urography or CT scan, has been reported in the literature for diagnosing MRKH. MRI is the mainstay of imaging in evaluating this syndrome, as it is free of radiation, non-invasive and has multiplanar capabilities.
Collapse
|
31
|
Presence of tracheal bronchus in children undergoing flexible bronchoscopy. Respir Med 2015; 109:846-50. [DOI: 10.1016/j.rmed.2015.04.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 04/11/2015] [Indexed: 11/19/2022]
|
32
|
Singh U, Jhim D, Kumar S, Mittal V, Singh N, Gour H, Ramaraj M. Unilateral agenesis of the lung: a rare entity. AMERICAN JOURNAL OF CASE REPORTS 2015; 16:69-72. [PMID: 25659613 PMCID: PMC4324577 DOI: 10.12659/ajcr.892385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Patient: Female, 15 Final Diagnosis: Unilateral agenesis of the lung Symptoms: Sore throat with dry cough Medication: — Clinical Procedure: Cect of the chest and bronchoscopy Specialty: Pulmonology
Collapse
Affiliation(s)
- Urvinderpal Singh
- Department of Pulmonary Medicine, Government Medical College, Patiala, Punjab, India
| | - Daksh Jhim
- Department of Pulmonary Medicine, Government Medical College, Patiala, Punjab, India
| | - Sunil Kumar
- Department of Pulmonary Medicine, Government Medical College, Patiala, Punjab, India
| | - Vidhu Mittal
- Department of Pulmonary Medicine, Government Medical College, Patiala, Punjab, India
| | - Navdeep Singh
- Department of Pulmonary Medicine, Government Medical College, Patiala, Punjab, India
| | - Hitesh Gour
- Department of Pulmonary Medicine, Government Medical College, Patiala, Punjab, India
| | - Muralidharan Ramaraj
- Department of Pulmonary Medicine, Government Medical College, Patiala, Punjab, India
| |
Collapse
|
33
|
|
34
|
Chawla RK, Madan A, Das K, Chawla A. Completely opaque hemithorax. Lung India 2014; 31:416-8. [PMID: 25378858 PMCID: PMC4220332 DOI: 10.4103/0970-2113.142095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Rakesh K Chawla
- Department of Respiratory Medicine, Critical Care and Sleep Disorders, Jaipur Golden Hospital, Rohini, Delhi, India
| | - Arun Madan
- Department of Pulmonary Medicine, Sharda Medical College and Hospital, Noida, India
| | - Kamanasish Das
- Department of Respiratory Medicine, Critical Care and Sleep Disorders, Jaipur Golden Hospital, Rohini, Delhi, India
| | - Aditya Chawla
- Shri Ram Murti Medical College, Bareilly, Uttar Pradesh, India
| |
Collapse
|
35
|
Russell BC, Whitecar P, Nitsche JF. Isolated unilateral pulmonary agenesis and other fetal thoracic anomalies. Obstet Gynecol Surv 2014; 69:335-45. [PMID: 25101843 DOI: 10.1097/ogx.0000000000000070] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
IMPORTANCE Although the diagnostic workup and management regimens for many of the common fetal thoracic lesions have been well described, the understanding of pulmonary agenesis is more limited. A better understanding of the published reports of this condition is essential to provide proper care for these complicated pregnancies. OBJECTIVE The aims of this study were to provide a better understanding of the difficulties in the diagnosis and management of fetal thoracic lesions and to consolidate what is known about unilateral pulmonary agenesis. EVIDENCE ACQUISITION We performed a review of the English medical literature covering the last 20 years (1993-2013) in PubMed, MEDLINE, and MD Consult using search terms pulmonary agenesis, pulmonary aplasia, unilateral pulmonary agenesis, unilateral pulmonary aplasia, lung agenesis, lung aplasia, unilateral lung agenesis, and unilateral lung aplasia. RESULTS Prenatal diagnosis of pulmonary agenesis and other fetal thoracic lesions can be particularly challenging given that many anomalies have similar appearance on ultrasound. Fetal magnetic resonance imaging has been used in several of the reported cases to clarify the diagnosis. Once confirmed, there are several important prognostic factors to consider in the management of unilateral pulmonary agenesis. Poor prognostic factors include right-sided agenesis, the presence of genetic abnormalities, and other associated congenital anomalies. CONCLUSION AND RELEVANCE Fetal magnetic resonance imaging can be a useful imaging modality when the diagnosis is unclear after ultrasound imaging. The management of cases with a poor prognosis should be guided by the nature of the associated anomalies. Cases of isolated pulmonary agenesis have an overall good prognosis and can be managed conservatively during pregnancy, with consideration of delivery at a tertiary care facility in case postnatal respiratory issues arise.
Collapse
Affiliation(s)
- Bronwyn C Russell
- Medical Student, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Paul Whitecar
- Associate Professor, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Joshua F Nitsche
- Assistant Professor, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Wake Forest University School of Medicine, Winston-Salem, NC
| |
Collapse
|
36
|
Pathania M, Lali BS, Rathaur VK. Unilateral pulmonary hypoplasia: a rare clinical presentation. BMJ Case Rep 2013; 2013:bcr-2012-008098. [PMID: 23519505 DOI: 10.1136/bcr-2012-008098] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The clinical presentation of an adolescent man with left lung hypoplasia is described in detail including the history and clinical examination findings. On further investigation, the chest x-ray and CT scan of the chest reveal interesting findings. Generally, such conditions are brought to notice in the early years of life but the presentation of this condition at the age of 18 years make it even more interesting and unique. This is a discussion of the management of such a patient and the different types of lung hypoplasia which can be encountered in clinical practice.
Collapse
Affiliation(s)
- Monika Pathania
- Department of Internal Medicine, VCSG Government Medical Sciences and Research Institute, Srinagar (Garhwal), India
| | | | | |
Collapse
|
37
|
Aggarwal R, Aggarwal M, Dwivedi S. Pulmonary hypoplasia and juvenile rheumatoid arthritis: A novel association. INDIAN JOURNAL OF RHEUMATOLOGY 2012. [DOI: 10.1016/j.injr.2012.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
38
|
Unilateral pulmonary hypoplasia with abdominal situs inversus. Indian J Pediatr 2012; 79:1360-2. [PMID: 22237637 DOI: 10.1007/s12098-011-0667-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Accepted: 12/16/2011] [Indexed: 10/14/2022]
Abstract
A case of unilateral pulmonary hypoplasia in association with abdominal situs inversus (Situs Inversus Partialis) is described here in a 2-mo-old baby. The normally related heart (levocardia) is dextroposed due to the hypoplastic right lung and compensatory hyper-inflation of the opposite lung which clinically mimicked a mirror-image situs inversus totalis. Such a combination, to the best of authors' knowledge, has never been reported in the world literature.
Collapse
|
39
|
Barison A, Ait-Ali L, Domenici R, Vaccaro A, Ruggieri S, Lombardi M, Festa P. Right lung agenesis and dextrocardia in a paucisymptomatic 11-year-old child. Int J Cardiol 2012; 158:e1-2. [PMID: 22088223 DOI: 10.1016/j.ijcard.2011.10.069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2011] [Accepted: 10/18/2011] [Indexed: 10/15/2022]
|
40
|
Ravindrakumar B, Devi VS, Rani UU. Pulmonary hypoplasia with hepatic and renal anomalies in a dead fetus. Lung India 2012; 29:163-5. [PMID: 22628933 PMCID: PMC3354492 DOI: 10.4103/0970-2113.95329] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Pulmonary hypoplasia is a developmental malformation characterized by incomplete development of lung tissue. During routine fetal autopsy of an apparently normal female dead fetus of 36 weeks gestation presented completely hypoplastic left lung, partially hypoplastic right lung, right-sided shift of heart, right-sided shift of trachea, left-sided diaphragmatic hernia through which an extra lobe from left lobe of liver extended into the left half of thoracic cavity. Left kidney was iliac in position.
Collapse
Affiliation(s)
- B Ravindrakumar
- Department of Anatomy, Sri Venkateswara Institue of Medical Scineces, Tirupati, Andhra Pradesh, India
| | | | | |
Collapse
|
41
|
Alsaadi M, Al Muqhem B, Boukai A, Iqbal SM. Unilateral primary pulmonary agenesis and hypoplasia in monozygotic twins. Ann Saudi Med 2012; 32:90-2. [PMID: 22156648 PMCID: PMC6087648 DOI: 10.5144/0256-4947.2012.90] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We describe 10-month-old identical female twin infants, one with primary left-sided pulmonary agenesis and the other with primary left-sided pulmonary hypoplasia. They came to our outpatient clinic complaining of persistent dry cough. The clinical examination revealed decreased air entry over the left hemithorax. Chest x-rays showed complete left-sided radio-opacity in both the twins. The chest computed tomography scan with contrast confirmed the diagnoses of left-sided pulmonary agenesis (twin A) and left-sided hypoplasia (twin B). No other associated congenital anomaly was noted in either of the twins. To our knowledge, such a condition in live monozygotic twins has not been previously reported in published studies.
Collapse
Affiliation(s)
- Muslim Alsaadi
- Department of Pediatrics, Division of Respiratory Medicine; Department of Radiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | | | | | | |
Collapse
|
42
|
Abstract
OBJECTIVE To present a case of foreign body aspiration in a child with unilateral lung aplasia and successful removal of the foreign body by bedside flexible bronchoscopy. DATA SOURCE Case details were obtained from medical records. STUDY SELECTION Eighteen-month-old girl with unilateral lung aplasia. DATA EXTRACTION AND SYNTHESIS Demographic details (age) and clinical and biochemical data (blood gas) were obtained from medical records. An 18-mo-old girl with the diagnosis of right lung aplasia, who underwent aortopexy in the newborn period for severe respiratory distress, presented with acute-onset respiratory distress. The patient was treated with bronchodilators and steroids without success and rapidly progressed to respiratory failure. Flexible bronchoscopy done at the bedside showed a foreign body completely obstructing the left main bronchus. The rigid bronchoscopy was unsuccessful in extracting the foreign body because of the complex airway anatomy. The foreign body was successfully extracted by basket forceps via a flexible bronchoscope, and the patient recovered remarkably within few hours of the procedure. CONCLUSIONS Because foreign body aspiration in a child with a unilateral lung can result in abrupt respiratory compromise and death, a high index of suspicion is necessary when these children present with acute respiratory symptoms. Although rigid bronchoscopy is the procedure of choice for the removal of foreign bodies, flexible bronchoscopy may be necessary for patients with abnormal airway anatomy.
Collapse
|
43
|
Roy PP, Datta S, Sarkar A, Das A, Das S. Unilateral pulmonary agenesis presenting in adulthood. Respir Med Case Rep 2011; 5:81-3. [PMID: 26057001 PMCID: PMC3920441 DOI: 10.1016/j.rmedc.2011.05.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Accepted: 05/25/2011] [Indexed: 11/27/2022] Open
Abstract
Agenesis of lung,a rare congenital anomaly,may present in adult life with features of recurrent chest infections and radiologically may mimic many common conditions presenting as opaque hemithorax with ipsilateral shifting of mediastinum.Here, a case of a young man presenting with frequent attacks of cough expectoration and progressive dyspnoea since childhood,proved to be a case of left pulmonary agenesis on CT scan and bronchoscopy, is to be discussed.
Collapse
Affiliation(s)
- Partha P Roy
- Medical College Kolkata, Pulmonary Medicine, 88, College Street, Kolkata 700073, West Bengal, India
| | - Samadarshi Datta
- Medical College Kolkata, Pulmonary Medicine, 88, College Street, Kolkata 700073, West Bengal, India
| | - Anirban Sarkar
- Medical College Kolkata, Pulmonary Medicine, 88, College Street, Kolkata 700073, West Bengal, India
| | - Anirban Das
- Medical College Kolkata, Pulmonary Medicine, 88, College Street, Kolkata 700073, West Bengal, India
| | - Soumya Das
- Medical College Kolkata, Pulmonary Medicine, 88, College Street, Kolkata 700073, West Bengal, India
| |
Collapse
|
44
|
Kisku KH, Panigrahi MK, Sudhakar R, Nagarajan A, Ravikumar R, Daniel JR. Agenesis of lung - a report of two cases. Lung India 2011; 25:28-30. [PMID: 20396661 PMCID: PMC2853047 DOI: 10.4103/0970-2113.44136] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Agenesis of lung is a rare congenital disorder. We are reporting varied degree of pulmonary agenesis in two adult patients.
Collapse
Affiliation(s)
- K H Kisku
- Department of Pulmonary Medicine, Pondicherry Institute of Medical Sciences, Pondicherry - 605014., India
| | | | | | | | | | | |
Collapse
|
45
|
Infected tracheocoele (acquired tracheal diverticulum): case report and literature review. The Journal of Laryngology & Otology 2011; 125:540-5. [PMID: 21310098 DOI: 10.1017/s0022215110003026] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Paratracheal air-filled cysts are rare. Tracheocoele or acquired tracheal diverticulum is the term given to these acquired abnormalities, which usually arise in adults. The majority is asymptomatic, being discovered as incidental findings on radiological imaging. METHODS We report the case of a 72-year-old man with a previously identified tracheocoele which became symptomatic following an upper respiratory tract infection. A literature is presented and nomenclature is discussed. RESULTS The clinical presentation, differential diagnosis and management of paratracheal air-filled cysts are discussed. CONCLUSION While most of these rare abnormalities are discovered incidentally, this case illustrates the fact that significant symptoms can develop; excision should therefore be considered.
Collapse
|
46
|
Affiliation(s)
- Shoaib Faruqi
- Department of Respiratory Medicine, Castle Hill Hospital, UK.
| | | | | | | |
Collapse
|
47
|
3D Imaging in Unilateral Primary Pulmonary Hypoplasia in an Adult: A Case Report. Case Rep Radiol 2011; 2011:659586. [PMID: 22606552 PMCID: PMC3350092 DOI: 10.1155/2011/659586] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Accepted: 08/16/2011] [Indexed: 11/26/2022] Open
Abstract
Unilateral primary pulmonary hypoplasia is rare in adulthood (UPHA); it is characterized by a decreased number of bronchial segmentation and decreased/absent alveolar air space. Classical chest X-ray may be confusing, and the biological tests are unspecific. We present a case of UPHA in a 60-year-old female, smoker, with 3 term normal deliveries, who presented with late recurrent pneumonias and bronchiectasis-type symptomathology, arterial hypertension, and obesity. Chest X-rays revealed opacity in the left lower pulmonary zone, an apparent hypoaerated upper left lobe and left deviation of the mediastinum. Preoperatory multidetector computer tomography (MDCT) presented a small retrocardiac left lung with 5-6 bronchial segmentation range and cystic appearance. After pneumonectomy the gross specimen showed a small lung with multiple bronchiectasis and small cysts, lined by hyperplasic epithelium, surrounded by stromal fibrosclerosis. We concluded that this UPHA occurred in the 4–7 embryonic weeks, and the 3D MDCT reconstructions offered the best noninvasive diagnosis.
Collapse
|
48
|
Reply. AJR Am J Roentgenol 2010. [DOI: 10.2214/ajr.10.4756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
49
|
Wijnands M, van Esch E. Skeletal muscle choristoma in the lung of a female Sprague-Dawley rat: a case report. ACTA ACUST UNITED AC 2010; 64:239-41. [PMID: 20926269 DOI: 10.1016/j.etp.2010.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Accepted: 08/18/2010] [Indexed: 10/19/2022]
Abstract
In this report we describe a choristoma in the lung of a female placebo rat. The lesion was observed microscopically in the central part of the left lung lobe and was characterized by a nodule consisting of well-differentiated skeletal muscle cells. The muscle fibers were haphazardly organized giving the nodule a poorly demarcated border. Choristoma is a very rare lesion.
Collapse
Affiliation(s)
- Marcel Wijnands
- Department of Toxicology & Drug Safety, Merck Sharpe & Dohme, Nistelrooisebaan 3, 5374 RE Schaijk, The Netherlands.
| | | |
Collapse
|
50
|
Suzuki M, Matsui O, Kawashima H, Takemura A, Matsubara K, Hayashi N, Koda W, Shibata Y. Radioanatomical study of a true tracheal bronchus using multidetector computed tomography. Jpn J Radiol 2010; 28:188-92. [PMID: 20437128 DOI: 10.1007/s11604-009-0405-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2009] [Accepted: 11/30/2009] [Indexed: 10/19/2022]
Abstract
PURPOSE True tracheal bronchus (TTB) is a rare anomaly in which a lobar or segmental ectopic bronchus arises from the trachea. We examined the frequency and multidetector computed tomography (MDCT) appearances of TTB. MATERIALS AND METHODS We retrospectively analyzed 9781 chest MDCT examinations. In cases in which there was an abnormal bronchus suggesting TTB on axial CT images, the following imaging of the abnormal bronchi was undertaken: multiplanar reformation (MPR), multiprojection volume reconstruction (MPVR), volume rendering (VR), and virtual endoscopy (VE). RESULTS Of 9781 MDCT examinations, 30 TTBs were observed in 10 females and 20 males. The frequency of TTB was 0.21% among 4622 females, 0.39% among 5159 males (0.31 % in the overall patient population). TTBs arose from the right lateral wall of the trachea; 17 TTBs were of the displaced type and 13 of the supernumerary type. With the displaced type, all segments of the right upper lobe were supplied by the TTB in 8 patients, and the apical segment was supplied in 8 patients. With the supernumerary type, TTBs showed blind termination in 10 patients, and the TTB had a small lobule in 3 patients. All TTBs were clearly visualized on MPR, MPVR, VR, and VE. CONCLUSION TTB was identified by MDCT with an incidence of 0.31%.
Collapse
Affiliation(s)
- Masayuki Suzuki
- Department of Quantum Medical Technology, Graduate School of Medical Science, Kanazawa University, Kodatsuno, Kanazawa, Japan.
| | | | | | | | | | | | | | | |
Collapse
|