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Monfregola A, De Angelis L, Comune R, Arienzo F, Barbato G, Di Stasio M, Pourmolkara D, Rosano N, Picchi SG, Galluzzo M, Granata V, Tamburrini S. Interlobar pulmonary sequestration with celiac aberrant artery in an elderly patient treated with combined endovascular and video-assisted thoracoscopic approach. Radiol Case Rep 2024; 19:3418-3424. [PMID: 38854910 PMCID: PMC11157120 DOI: 10.1016/j.radcr.2024.05.018] [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: 04/21/2024] [Revised: 05/02/2024] [Accepted: 05/03/2024] [Indexed: 06/11/2024] Open
Abstract
Pulmonary sequestration is a rare congenital pulmonary anomaly where a portion of the lung parenchyma is supplied by an anomalous systemic artery, usually originating from the thoracic or abdominal aorta. Traditionally surgical resection and ligation of the aberrant feeding vessel are the gold standard treatments of this disease. Hybrid operations consisting in endovascular arterial embolization and surgical resection is a promising treatment option. We report a case of a 69-years-old man with symptomatic intralobular sequestration successfully treated by hybrid approach.
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Affiliation(s)
| | - Leda De Angelis
- Division of Radiology, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Rosita Comune
- Division of Radiology, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Francesco Arienzo
- Department of Interventional Radiology, Ospedale del Mare, ASL NA1 Centro, Naples, Italy
| | - Giovanni Barbato
- Division of Radiology, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Mario Di Stasio
- Department of Thoracic Surgery, Ospedale del Mare, ASL NA1 Centro, Naples, Italy
| | - Domenico Pourmolkara
- Department of Thoracic Surgery, Ospedale del Mare, ASL NA1 Centro, Naples, Italy
| | - Nicola Rosano
- Department of Radiology, Ospedale del Mare, ASL NA1 Centro, Naples, Italy
| | | | - Michele Galluzzo
- Department of Emergency Radiology, San Camillo Forlanini Hospital, Rome, Italy
| | - Vincenza Granata
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS di Napoli, Naples, Italy
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2
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Ji S, Zhang H, Guan Y, Song C, Han M. Analysis of imaging in pediatric bronchopulmonary foregut malformations with literature review: case reports. Front Pediatr 2024; 12:1400124. [PMID: 38813545 PMCID: PMC11133687 DOI: 10.3389/fped.2024.1400124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 04/26/2024] [Indexed: 05/31/2024] Open
Abstract
Background Bronchopulmonary foregut malformation (BPFM) is an uncommon condition, with few case reports documented in both national and international literature. This scarcity underscores the importance of utilizing effective imaging techniques to improve our understanding and diagnostic precision concerning this disorder. Case description In the first case report, a neonate, born at full term and aged 15 days, presented with symptoms including dyspnea, coughing, wheezing, cyanosis, and vomiting. Initial diagnostic evaluations, which included chest radiography and upper gastrointestinal tract radiography, led to an erroneous initial diagnosis of a left-sided diaphragmatic hernia, accompanied by a suspicion of infection. In the second case report, another neonate, also born at full term but aged 5 days, exhibited symptoms such as coughing, choking, and mild vomiting. Utilizing a combination of computed tomography (CT) scans (plain, enhanced, and reconstructed), chest x-ray, and upper gastrointestinal tract radiography, the diagnosis of BPFM was accurately determined. Conclusion Comprehensive imaging examinations play a crucial role in reducing misdiagnosis and diagnostic oversights in cases of BPFM. Given its rarity, BPFM often manifests as a sequestered lung accompanied by gastrointestinal abnormalities. Hence, the integration of CT scans with gastrointestinal tract radiography can substantially improve diagnostic precision in such cases.
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Affiliation(s)
| | | | | | | | - Meirong Han
- Department of Radiology, Shanxi Children’s Hospital and Women Health Center of Shanxi, Taiyuan, Shanxi, China
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3
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Computed tomography of the airways and lungs in congenital heart disease. Pediatr Radiol 2022; 52:2529-2537. [PMID: 34562108 DOI: 10.1007/s00247-021-05186-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/21/2021] [Accepted: 08/12/2021] [Indexed: 10/20/2022]
Abstract
The presence of airway and lung disease in children with congenital heart disease is commonly observed with both cardiac CT angiography and routine chest CT. In this review we discuss abnormalities encountered on CT imaging of the chest beyond the heart and central vasculature, focusing on the airways, lung parenchyma and peripheral vasculature. Preoperative and postoperative findings are reviewed as well.
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4
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Bonnet D, Szezepanski I, Delacourt C, Malkezadeh-Milani S, Lévy M. Multifactorial pulmonary hypertension in infantile scimitar syndrome. Arch Cardiovasc Dis 2022; 115:142-150. [DOI: 10.1016/j.acvd.2022.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 11/29/2022]
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5
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Imaging of congenital lung diseases presenting in the adulthood: a pictorial review. Insights Imaging 2021; 12:153. [PMID: 34716817 PMCID: PMC8557233 DOI: 10.1186/s13244-021-01095-2] [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: 07/22/2021] [Accepted: 09/13/2021] [Indexed: 11/15/2022] Open
Abstract
Congenital lung diseases in adults are rare diseases that can present with symptoms or be detected incidentally. Familiarity with the imaging features of different types of congenital lung diseases helps both in correct diagnosis and management of these diseases. Congenital lung diseases in adults are classified into three main categories as bronchopulmonary anomalies, vascular anomalies, and combined bronchopulmonary and vascular anomalies. Contrast-enhanced computed tomography, especially 3D reconstructions, CT, or MR angiography, can show vascular anomalies in detail. The tracheobronchial tree, parenchymal changes, and possible complications can also be defined on chest CT, and new applications such as quantitative 3D reconstruction CT images, dual-energy CT (DECT) can be helpful in imaging parenchymal changes. In addition to the morphological assessment of the lungs, novel MRI techniques such as ultra-short echo time (UTE), arterial spin labeling (ASL), and phase-resolved functional lung (PREFUL) can provide functional information. This pictorial review aims to comprehensively define the radiological characteristics of each congenital lung disease in adults and to highlight differential diagnoses and possible complications of these diseases.
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6
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Weon JL, Megison S, Timmons CF, Rakheja D. Esophagus-Like Bronchus: A Noncommunicating Bronchopulmonary Foregut Malformation. Int J Surg Pathol 2021; 29:847-849. [PMID: 33709821 DOI: 10.1177/10668969211002255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We describe a previously unreported bronchopulmonary foregut malformation wherein a segment of a bronchus of the lower lobe of the left lung in a 4-year-old girl was entirely esophageal in structure. No communication was identified between the tracheobronchial tree and the esophagus by radiologic examination or at surgery. The esophagus-like bronchus was associated with an adjacent atretic bronchus and a downstream cavity in the lower lobe of the left lung. The child sought clinical attention because of recurrent pulmonary infections localized to the lower lobe of the lung. We posit that this esophagus-like bronchus is a novel noncommunicating bronchopulmonary foregut malformation.
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Affiliation(s)
- Jenny L Weon
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Stephen Megison
- University of Texas Southwestern Medical Center, Dallas, TX, USA.,Children's Health, Dallas, TX, USA
| | - Charles F Timmons
- University of Texas Southwestern Medical Center, Dallas, TX, USA.,Children's Health, Dallas, TX, USA
| | - Dinesh Rakheja
- University of Texas Southwestern Medical Center, Dallas, TX, USA.,Children's Health, Dallas, TX, USA
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7
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Luke K, Thomas R, Tudor G. An easily overlooked cause of haemoptysis and heart failure; anomalous systemic arterial supply to normal lung. BJR Case Rep 2020; 6:20190089. [PMID: 33029369 PMCID: PMC7527006 DOI: 10.1259/bjrcr.20190089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 11/18/2019] [Accepted: 11/20/2019] [Indexed: 11/05/2022] Open
Abstract
Systemic arterial supply to a segment of normal lung is rare. 1 Usually the anomalous systemic artery arises from the descending aorta, although it can arise from other sites including the coeliac axis. 1–3 Case reports documenting an anomalous artery to normal lung from the coeliac axis are few. However, in these cases the patients were being investigated for respiratory symptoms and all were under the age of 50. In our case, we describe a rare case of anomalous systemic arterial supply arising from the coeliac axis to the right lower lobe, in the absence of abnormal bronchial connection or parenchymal disease in an asymptomatic patient. The anomalous arterial supply was an incidental finding on CT. The literature suggests surgical treatment to prevent symptoms of haemoptysis or congestive cardiac failure, but it is unclear from current evidence whether this is indicated in an asymptomatic patient.
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Affiliation(s)
- Katherine Luke
- Department of Radiology, University Hospital of Wales, Cardiff and Vale University Health Board, Wales, UK
| | - Rhys Thomas
- Department of Radiology, University Hospital of Wales, Cardiff and Vale University Health Board, Wales, UK
| | - Gareth Tudor
- Department of Radiology, Princess of Wales Hospital, Cwm Taf Morgannwg University Health Board, Wales, UK
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8
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Marini TJ, He K, Hobbs SK, Kaproth-Joslin K. Pictorial review of the pulmonary vasculature: from arteries to veins. Insights Imaging 2018; 9:971-987. [PMID: 30382495 PMCID: PMC6269336 DOI: 10.1007/s13244-018-0659-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 08/14/2018] [Accepted: 09/12/2018] [Indexed: 01/27/2023] Open
Abstract
Pathology of the pulmonary vasculature involves an impressive array of both congenital and acquired conditions. While some of these disorders are benign, disruption of the pulmonary vasculature is often incompatible with life, making these conditions critical to identify on imaging. Many reviews of pulmonary vascular pathology approach the pulmonary arteries, pulmonary veins and bronchial arteries as individual topics. The goal of this review is to provide an integrated overview of the high-yield features of all major disorders of the pulmonary vasculature. This approach provides a more cohesive and comprehensive conceptualisation of respiratory pathology. In this review, we present both the salient clinical and imaging features of congenital and acquired disorders of the pulmonary vasculature, to assist the radiologist in identifying pathology and forming a robust differential diagnosis tailored to the presenting patient. TEACHING POINTS: • Abnormalities of the pulmonary vasculature are both congenital and acquired. • Pathology of a single pulmonary vascular territory often affects the entire pulmonary vasculature. • Anomalous pulmonary venous flow is named as a function of its location and severity. • Bronchial arteries often undergo dilatation secondary to cardio-respiratory pathology.
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Affiliation(s)
- Thomas J Marini
- Department of Imaging Sciences, University of Rochester, Rochester, NY, USA.
| | - Kevin He
- Department of Imaging Sciences, University of Rochester, Rochester, NY, USA
| | - Susan K Hobbs
- Department of Imaging Sciences, University of Rochester, Rochester, NY, USA
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9
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Expression Analysis of ACSL5 and Wnt2B in Human Congenital Pulmonary Airway Malformations. J Surg Res 2018; 232:128-136. [PMID: 30463708 DOI: 10.1016/j.jss.2018.06.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 04/22/2018] [Accepted: 06/06/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND The objective of this study was to determine acyl-CoA synthetase 5 (ACSL5) and Wnt2B expression patterns in human congenital pulmonary airway malformations (CPAMs) and to identify the possible roles of ACSL5 and Wnt2B in the pathogenesis of CPAM. METHODS Expression of ACSL5 and Wnt2B was evaluated by immunohistochemical staining, Western blotting, and quantitative real-time polymerase chain reaction, which were performed on surgical specimens of CPAM and adjacent normal lung tissues as controls. RESULTS Immunohistochemistry revealed that ACSL5 and Wnt2B immunopositive cells were predominantly detected in the mesenchymal cell nucleus, and there were lower expressions of ACSL5 and Wnt2B immunopositive cells in CPAM tissues than those in adjacent normal lung tissues. Western blotting and quantitative real-time polymerase chain reaction showed that ACSL5 and Wnt2B protein and mRNA expressions were significantly decreased in CPAM tissues as compared to the adjacent normal lung tissues (P < 0.05). In addition, there was a reduced level of ACSL5 relative to that of Wnt2B. CONCLUSIONS The decreased ACSL5 and Wnt2B expressions correlated with aberrations in pulmonary development and in the pathogenesis of CPAM, so downregulation of ACSL5 and Wnt2B could play an important role in the development of bronchial-alveolar structures in CPAM.
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10
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Cardiorespiratory Interactions in Paediatrics: 'It's (almost always) the circulation stupid!'. Paediatr Respir Rev 2017; 22:60-65. [PMID: 28029591 DOI: 10.1016/j.prrv.2016.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 08/09/2016] [Indexed: 11/20/2022]
Abstract
The interaction of the heart and lungs is probably the most important aspect of life and survival. Fortunately, it is not difficult to understand the fundamentals. The purpose of the lungs and their ventilation is to present oxygen to the circulation via the alveoli and to receive carbon dioxide from the circulation and then expel it. The relations of the heart and lungs and the matching of blood flow to the various organs with ventilation and lung perfusion may be disrupted by a variety of congenital or acquired heart malformations. They include those giving rise to an increased or reduced pulmonary blood flow, elevated pulmonary venous pressure or external physical pressure on the airways or lung parenchyma. Respiratory disorders which compromise cardiac function include states with reduced alveolar ventilation, those with a barrier to ventilation or perfusion, ventilation/perfusion mismatch and pulmonary vascular disease. There is also a fascinating group in which congenital disorders of the heart and lung co-exist to produce very particular modes of abnormal cardiopulmonary interaction.
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11
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Gorospe L, Muñoz-Molina GM, Ayala-Carbonero AM, Fernández-Méndez MÁ, Arribas-Marcos Á, Castro-Acosta P, Arrieta P, García-Gómez-Muriel I, Gómez-Barbosa CF, Barrios-Barreto D. Cystic adenomatoid malformation of the lung in adult patients: clinicoradiological features and management. Clin Imaging 2016; 40:517-22. [DOI: 10.1016/j.clinimag.2015.11.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 11/05/2015] [Indexed: 01/13/2023]
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12
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Abstract
We present a rare case of scimitar syndrome in which the scimitar vessel, collecting all the right pulmonary veins, was stenotic at its junction, with the inferior caval vein and two anomalous vessels, connecting to the same venous collector, draining most of the flow to the left atrium. We arbitrarily defined this rare anatomical variant as a congenitally palliated scimitar syndrome.
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13
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Abstract
The Scimitar syndrome is a complex association of cardiovascular and bronchopulmonary abnormalities, with the main feature a partial or total anomalous right pulmonary venous drainage to the inferior vena cava. A number of cases that lack of all the features of the typical syndrome have been described as Scimitar variant, but the incidence is rare. Familial occurrence is exceptional and limited to few cases in literature. We report two sibling diagnosed with an uncommon variant of the Scimitar syndrome.
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Affiliation(s)
- Ilaria Bo
- Division of Paediatric Cardiology, Royal Brompton Hospital, London, United Kingdom
| | - Piers E F Daubeney
- Division of Paediatric Cardiology, Royal Brompton Hospital, London, United Kingdom ; Reader in Paediatric Cardiology at Imperial College, London, United Kingdom
| | - Michael L Rigby
- Division of Paediatric Cardiology, Royal Brompton Hospital, London, United Kingdom
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14
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Lloyd IE, Rowe LR, Erickson LK, Paxton CN, South ST, Alashari M. Two cases of Scimitar syndrome associated with multiple congenital skeletal anomalies and lacking abnormalities by genomic microarray analysis. Pediatr Dev Pathol 2014; 17:360-5. [PMID: 24945981 DOI: 10.2350/14-04-1474-cr.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Scimitar syndrome is a congenital anomaly occurring in approximately 1/50,000 births, consisting of partial anomalous pulmonary venous return, right lung hypoplasia, and several associated defects. The condition generally has significant morbidity and mortality, but the underlying cause is poorly understood. In this report, we describe 2 autopsy cases of Scimitar syndrome associated with multiple skeletal anomalies and attempt to characterize possible genetic abnormalities in this condition. In light of these findings, we discuss the embryology and direct timing during development of the anomalies associated with this syndrome.
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Affiliation(s)
- Isaac E Lloyd
- 1 Department of Pathology, University of Utah, 15 North Medical Drive East, Suite #1100, Salt Lake City, UT 84112, USA
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15
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Berteloot L, Bobbio A, Millischer-Bellaïche AE, Lambot K, Breton S, Brunelle F. [Congenital malformations of the lung, the radiologist's point of view]. Rev Mal Respir 2012; 29:820-35. [PMID: 22742469 DOI: 10.1016/j.rmr.2011.10.976] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2011] [Accepted: 10/03/2011] [Indexed: 10/28/2022]
Abstract
Congenital lung malformations include a complex range of developmental abnormalities. Currently, most are diagnosed prenatally or during early childhood. They may, however, be discovered later, incidentally or in connection with non-specific symptoms, sometimes severe. Knowledge of their radiological appearances is necessary for their detection. Proper technique and analysis of cross-sectional imaging, computed tomography and magnetic resonance imaging, allow a definitive diagnosis in most patients and pre-treatment evaluation of surgical cases. This review will describe the radiological aspects of congenital pulmonary malformations, especially those which may occur in late childhood or adult life. When present, alternative diagnoses will be discussed. A distinction will be made between anomalies originating from bronchopulmonary structures, such as bronchial atresia, bronchogenic cyst, congenital lobar overinflation, cystic adenomatoid malformation, and forms related to vascular anomalies (vascular rings, anomalous left pulmonary artery, pulmonary underdevelopment, proximal interruption of the pulmonary artery, pulmonary sequestration, scimitar syndrome).
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Affiliation(s)
- L Berteloot
- Service de radiologie pédiatrique, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France.
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16
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Fagman H, Amendola E, Parrillo L, Zoppoli P, Marotta P, Scarfò M, De Luca P, de Carvalho DP, Ceccarelli M, De Felice M, Di Lauro R. Gene expression profiling at early organogenesis reveals both common and diverse mechanisms in foregut patterning. Dev Biol 2011; 359:163-75. [PMID: 21924257 PMCID: PMC3206993 DOI: 10.1016/j.ydbio.2011.08.015] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Accepted: 08/24/2011] [Indexed: 11/30/2022]
Abstract
The thyroid and lungs originate as neighboring bud shaped outgrowths from the midline of the embryonic foregut. When and how organ specific programs regulate development into structures of distinct shapes, positions and functions is incompletely understood. To characterize, at least in part, the genetic basis of these events, we have employed laser capture microdissection and microarray analysis to define gene expression in the mouse thyroid and lung primordia at E10.5. By comparing the transcriptome of each bud to that of the whole embryo as well as to each other, we broadly describe the genes that are preferentially expressed in each developing organ as well as those with an enriched expression common to both. The results thus obtained provide a valuable resource for further analysis of genes previously unrecognized to participate in thyroid and lung morphogenesis and to discover organ specific as well as common developmental mechanisms. As an initial step in this direction we describe a regulatory pathway involving the anti-apoptotic gene Bcl2 that controls cell survival in early thyroid development.
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Affiliation(s)
| | - Elena Amendola
- IRGS, Biogem, Ariano Irpino (AV), Italy
- Stazione Zoologica Anton Dohrn, Naples, Italy
| | | | | | | | | | | | | | - Michele Ceccarelli
- IRGS, Biogem, Ariano Irpino (AV), Italy
- Dipartimento di Scienze Biologiche ed Ambientali, Università del Sannio, Benevento, Italy
| | - Mario De Felice
- IRGS, Biogem, Ariano Irpino (AV), Italy
- Dipartimento di Biologia e Patologia, Università di Napoli Federico II, Naples, Italy
| | - Roberto Di Lauro
- IRGS, Biogem, Ariano Irpino (AV), Italy
- Dipartimento di Biologia e Patologia, Università di Napoli Federico II, Naples, Italy
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17
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Jeewa A, Culham JAG, Human DG. A case of horseshoe lung and complex congenital heart disease in a term newborn. Pediatr Radiol 2010; 40:206-9. [PMID: 19771424 DOI: 10.1007/s00247-009-1401-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2009] [Revised: 08/04/2009] [Accepted: 08/24/2009] [Indexed: 10/20/2022]
Abstract
We describe and illustrate a rare association of hypoplastic left heart syndrome, absent hilar left pulmonary artery, and an unusual bronchopulmonary malformation. This case highlights the utility of combination imaging of echocardiography and CT angiography in diagnosing a cyanotic newborn with a chest radiograph that is suspicious for lung hypoplasia.
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Affiliation(s)
- Aamir Jeewa
- Department of Pediatrics, Division of Cardiology, British Columbia Children's Hospital & University of British Columbia, Vancouver, Canada
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18
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Complete congenital obstruction of a scimitar vein in an infant with severe respiratory failure. Cardiol Young 2009; 19:524-6. [PMID: 19671218 DOI: 10.1017/s1047951109990825] [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] [Indexed: 11/06/2022]
Abstract
We report an infant of 3 1/2 months with complete obstruction of the venous component of the scimitar syndrome, a large atrial septal defect within the oval fossa, a common left pulmonary vein, and pulmonary hypertension. To the best of our knowledge, ours is the first description of complete congenital obstruction of a scimitar vein.
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19
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Borges AC, Knebel F, Lembcke A, Panda A, Komoda T, Hiemann NE, Meyer R, Baumann G, Hetzer R. Bronchogenic cyst of the interatrial septum presenting as atrioventricular block. Ann Thorac Surg 2009; 87:1920-3. [PMID: 19463622 DOI: 10.1016/j.athoracsur.2008.10.051] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2008] [Revised: 10/01/2008] [Accepted: 10/12/2008] [Indexed: 11/15/2022]
Abstract
Bronchogenic cysts are congenital lesions that are a remnant from abnormal budding of the embryonic foregut. These cysts are usually single; most cases are either asymptomatic or present with respiratory symptoms. A 43-year-old woman presented with intermittent type II atrioventricular block during cholecystectomy. The cardiac evaluation including transthoracic and transesophageal echocardiography and magnetic resonance imaging revealed a cystic homogeneous mass within the interatrial septum. The patient underwent surgical resection of the mass and closure of the septal defect. Histopathology identified ciliated columnar epithelium, consistent with the diagnosis of a bronchogenic cyst.
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Affiliation(s)
- Adrian C Borges
- Department of Cardiology and Angiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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20
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Volpe MV, Chung E, Ulm JP, Gilchrist BF, Ralston S, Wang KT, Nielsen HC. Aberrant cell adhesion molecule expression in human bronchopulmonary sequestration and congenital cystic adenomatoid malformation. Am J Physiol Lung Cell Mol Physiol 2009; 297:L143-52. [PMID: 19411307 DOI: 10.1152/ajplung.90618.2008] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In many organs, integrins and cadherins are partly regulated by Hox genes, but their interactions in airway morphogenesis and congenital lung diseases are unknown. We previously showed that the Hox protein HoxB5 is abnormally increased in bronchopulmonary sequestration (BPS) and congenital cystic adenomatoid malformation (CCAM), congenital lung lesions with abnormal airway branching. We now report on alpha(2)-, alpha(3)-, and beta(1)-integrin and E-cadherin expression in normal human lung and in BPS and CCAM tissue previously shown to have abnormal HoxB5 expression and on the relationship of cell adhesion molecule expression to Hoxb5 regulation. alpha(2)-, alpha(3)-, and beta(1)-integrins and E-cadherin expression in normal human lung and BPS and CCAM were evaluated using Western blot and immunohistochemistry. Fetal mouse lung fibroblasts with Hoxb5-specific siRNA downregulation were evaluated for alpha(2)-integrin protein levels by Western blot. Compared with normal human lung, a previously undetected alpha(2)-integrin isoform potentially lacking essential cytoplasmic sequences was significantly increased in BPS and CCAM, and alpha(2)-integrin spatial and cellular expression was more intense. E-cadherin protein levels were also significantly increased, whereas alpha(3) increased in CCAM compared with canalicular, but not with alveolar, stage lung. beta(1)-integrin levels were unchanged. We conclude that in BPS and CCAM, altered alpha(2)-integrin cytoplasmic signaling contributes to abnormal cellular behavior in these lung lesions. Aberrant cell adhesion molecule and Hox protein regulation are likely part of the mechanism involved in the development of BPS and CCAM.
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Affiliation(s)
- Maryann V Volpe
- Department of Pediatrics, Division of Newborn Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts 02111, USA.
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21
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Lee EY, Boiselle PM, Cleveland RH. Multidetector CT evaluation of congenital lung anomalies. Radiology 2008; 247:632-48. [PMID: 18487532 DOI: 10.1148/radiol.2473062124] [Citation(s) in RCA: 109] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Congenital lung anomalies vary widely in their clinical manifestation and imaging appearance. Although radiographs play a role in the incidental detection and initial imaging evaluation in patients with clinical suspicion of congenital lung anomalies, cross-sectional imaging such as computer tomography (CT) is frequently required for confirmation of diagnosis, further characterization, and preoperative evaluation in the case of surgical lesions. Recently, with the development and widespread availability of multidetector CT scanners, CT has assumed a greater role in the noninvasive evaluation of congenital lung anomalies. The combination of fast speed, high spatial resolution, and enhanced quality of multiplanar reformation and three-dimensional reconstructions makes multidetector CT an ideal noninvasive method for evaluating congenital lung anomalies. In this article, the authors review the multidetector CT technique for evaluation of congenital lung anomalies. Important clinical aspects, characteristic imaging features, and key points that allow differentiation among various anomalies are highlighted for a variety of common and uncommon conditions.
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Affiliation(s)
- Edward Y Lee
- Departments of Radiology and Medicine, Pulmonary Division, Children's Hospital Boston and Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, USA.
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Gudbjartsson T, Oddsson SJ, Torfason B. Bilateral Extralobar Pulmonary Sequestration Communicating With the Upper Gastrointestinal System in a Newborn With Duodenal Atresia. Ann Thorac Surg 2007; 84:1380-1. [PMID: 17889006 DOI: 10.1016/j.athoracsur.2007.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2007] [Revised: 04/29/2007] [Accepted: 05/01/2007] [Indexed: 10/22/2022]
Abstract
We report a rare form of bilateral pulmonary sequestration (PS) that was directly connected to the gastroesophageal junction with a well-formed aberrant bronchus-like structure. An upper gastrointestinal contrast series was performed directly after birth, and a unique PS bronchogram was identified, along with duodenal atresia. The PS was successfully resected and the duodenal atresia was corrected.
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Affiliation(s)
- Tomas Gudbjartsson
- Department of Cardiothoracic Surgery, Landspitali University Hospital, Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
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23
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Anderson RH. Solving the disputes concerning the congenitally malformed heart. PROGRESS IN PEDIATRIC CARDIOLOGY 2006. [DOI: 10.1016/j.ppedcard.2006.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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