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Zhang X, Patil D, Odze RD, Zhao L, Lisovsky M, Guindi M, Riddell R, Bellizzi A, Yantiss RK, Nalbantoglu I, Appelman HD. The microscopic anatomy of the esophagus including the individual layers, specialized tissues, and unique components and their responses to injury. Ann N Y Acad Sci 2018; 1434:304-318. [PMID: 29761508 DOI: 10.1111/nyas.13705] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 02/27/2018] [Accepted: 03/11/2018] [Indexed: 02/05/2023]
Affiliation(s)
- Xuchen Zhang
- Department of PathologyYale University New Haven Connecticut
| | - Deepa Patil
- Department of PathologyCleveland Clinic Cleveland Ohio
| | - Robert D. Odze
- Department of Pathology, Brigham and Women's Hospital Boston Massachusetts
- Department of PathologyHarvard University Boston Massachusetts
| | - Lei Zhao
- Department of Pathology, Brigham and Women's Hospital Boston Massachusetts
- Department of PathologyHarvard University Boston Massachusetts
| | - Mikhail Lisovsky
- Department of PathologyDartmouth University Lebanon New Hampshire
| | - Maha Guindi
- Department of Pathology and Laboratory MedicineCedars‐Sinai Hospital Los Angeles California
| | - Robert Riddell
- Department of Pathology and Laboratory MedicineMount Sinai Hospital Toronto Ontario
- Department of Laboratory Medicine and PathobiologyUniversity of Toronto Toronto Ontario
| | | | - Rhonda K. Yantiss
- Department of Pathology and Laboratory MedicineWeill Cornell Medicine New York New York
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Ferreira CR, Sibre V, Schultz R, de Melo AMAGP, Ibidi SM, Torre JD. Congenital generalized lymphangiectasia: a rare developmental disorder for non-immune fetal hydrops. AUTOPSY AND CASE REPORTS 2016; 5:27-33. [PMID: 26894043 PMCID: PMC4757917 DOI: 10.4322/acr.2015.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 11/17/2015] [Indexed: 11/23/2022] Open
Abstract
Firstly described by Rudolf Virchow in the 19th century, congenital generalized lymphangiectasia is a rare entity characterized by dilation of lymphatic vessels, and was recently classified in primary or secondary lymphangiectasia. Generalized forms may be diagnosed during pre-natal follow-up with ultrasound examination, and, depending on its severity, the newborn outcome is very poor. The authors report the case of a female newborn with a previous diagnosis of fetal hydropsy who was born after a full-term gestation with respiratory failure due to bilateral voluminous pleural effusion and ascites. Physical examination also disclosed syndromic facies. Despite all efforts of the intensive supportive care, the patient died after 24 days of life. The autopsy findings were consistent with the diagnosis of congenital pulmonary lymphangiectasia. The authors call attention to this rare diagnosis in patients with cavitary effusion and respiratory insufficiency at birth.
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Affiliation(s)
- Cristiane Rúbia Ferreira
- Anatomy Pathology Service - Hospital Universitário - University of São Paulo, São Paulo/SP - Brazil
| | - Verônica Sibre
- Department of Pathology - Hospital das Clínicas - University of São Paulo, São Paulo/SP - Brazil
| | - Regina Schultz
- Department of Pathology - Faculty of Medicine - University of São Paulo, São Paulo/SP - Brazil.; Anatomy Pathology Service - Instituto do Cancer de São Paulo, São Paulo/SP - Brazil
| | | | - Silvia Maria Ibidi
- Pediatrics Division - Hospital Universitário - University of São Paulo, São Paulo/SP - Brazil
| | - Jackeline Della Torre
- Pediatrics Department - Faculty of Medicine - University of São Paulo, São Paulo/SP - Brazil
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Hwang JH, Kim JH, Hwang JJ, Kim KS, Kim SY. Pneumonectomy case in a newborn with congenital pulmonary lymphangiectasia. J Korean Med Sci 2014; 29:609-13. [PMID: 24753713 PMCID: PMC3991809 DOI: 10.3346/jkms.2014.29.4.609] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 09/30/2013] [Indexed: 11/20/2022] Open
Abstract
Congenital pulmonary lymphangiectasia (CPL) is a rare lymphatic pulmonary abnormality. CPL with respiratory distress has a poor prognosis, and is frequently fatal in neonates. We report a case of pneumonectomy for CPL in a newborn. An infant girl, born at 39 weeks' after an uncomplicated pregnancy, exhibited respiratory distress 1 hr after birth, which necessitated intubation and aggressive ventilator care. Right pneumonectomy was performed after her symptoms worsened. Histologic examination indicated CPL. She is currently 12 months old and developing normally. Pneumonectomy can be considered for treating respiratory symptoms for improving chances of survival in cases with unilateral CPL.
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Affiliation(s)
- Joon Ho Hwang
- Department of Pediatrics, Eulji University College of Medicine, Daejeon, Korea
| | - Joo Heon Kim
- Department of Thorasic and Cardiovascular Surgery, Eulji University College of Medicine, Daejeon, Korea
| | - Jung Ju Hwang
- Department of Pathology, Eulji University College of Medicine, Daejeon, Korea
| | - Kyu Soon Kim
- Department of Radiology, Eulji University College of Medicine, Daejeon, Korea
| | - Seung Yeon Kim
- Department of Pediatrics, Eulji University College of Medicine, Daejeon, Korea
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Nouri-Merchaoui S, Mahdhaoui N, Yacoubi MT, Seboui H. [Congenital pulmonary lymphangiectasis: an unusual cause of respiratory distress in neonates]. Arch Pediatr 2012; 19:408-12. [PMID: 22381667 DOI: 10.1016/j.arcped.2012.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 09/30/2011] [Accepted: 01/16/2012] [Indexed: 11/25/2022]
Abstract
Congenital pulmonary lymphangiectasis (CPL) is a rare condition in neonates characterized by abnormal dilatation of the lymphatics draining the interstitial and subpleural spaces of the lungs. Diagnosis is difficult in the neonatal period because respiratory features and radiological findings are not specific of the disease. Definitive diagnosis of CPL can be made only by pathologic examinations. We report a case of a male near-term neonate presenting with severe respiratory distress at birth. The initial chest X-ray showed frosted glass-like infiltrates with air bronchogram suggesting a maternofetal infection or respiratory distress syndrome. The infant required mechanical ventilation and chest tube insertion for right then bilateral pneumothorax. The child died 15 days later in spite of optimal high-frequency ventilation, bilateral pneumothorax drainage, and hemodynamic support. Autopsy revealed features consistent with the diagnosis of CPL. Although CPL is very rare, we should be aware that it is a possible cause of severe unexplained respiratory distress in neonates.
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Congenital pulmonary lymphangiectasis: Report of an autopsy case masquerading as pulmonary interstitial emphysema. Pathol Res Pract 2010; 206:522-6. [DOI: 10.1016/j.prp.2010.02.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2009] [Revised: 02/09/2010] [Accepted: 02/13/2010] [Indexed: 11/23/2022]
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Xiao ZY, Tao Y, Tang XY, Chen GJ, Guo L. Congenital pulmonary lymphangiectasis. World J Pediatr 2009; 5:68-70. [PMID: 19172338 DOI: 10.1007/s12519-009-0014-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2007] [Accepted: 04/10/2008] [Indexed: 11/28/2022]
Abstract
BACKGROUND Congenital pulmonary lymphangiectasis (CPL) characterized by dilatation of pulmonary lymphatic vessels occurs as a congenital anomaly. With poor prognosis, neonatal presentation of bilateral CPL is associated with the severe compromise of pulmonary gas exchange and high mortality. METHODS A male infant born at 39 weeks of gestation was found to have CPL. Cyanosis and cardiac arrest occurred a few minutes after birth, and the symptoms remained after artificial ventilation. The infant died of hypoxemic cardiac failure 45 minutes after birth. Autopsy showed neither pleural effusion nor valvular abnormalities. RESULTS Microscopically dilated vessels with lymphatics were seen in the lung of the infant. Atelectasis, CPL, inhalation of amniotic fluid, partial hydropic degeneration of hepatic cells, and scrotal edema were diagnosed. CONCLUSION With regard to treatment and prognosis, CPL must be distinguished from interstitial emphysema and other diseases.
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Affiliation(s)
- Zuo-Yuan Xiao
- Department of General Pediatrics, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
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Eom M, Choi YD, Kim YS, Cho MY, Jung SH, Lee HY. Clinico-pathological characteristics of congenital pulmonary lymphangiectasis: report of two cases. J Korean Med Sci 2007; 22:740-5. [PMID: 17728521 PMCID: PMC2693831 DOI: 10.3346/jkms.2007.22.4.740] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Congenital pulmonary lymphangiectasis (CPL) is a rare, poorly documented disease, characterized by abnormal dilatation of pulmonary lymphatics without lymphatic proliferation. This disease is seen almost exclusively in infancy and early childhood. It can usually be divided into primary (congenital) and secondary forms. The primary form presents in neonates, and the patients mostly die due to the respiratory distress, shortly after birth. The authors experienced two cases of primary CPL in a 13-day-old male neonate and a one-day-old male neonate, showing prominent lymphatic dilatation in the septal, subpleural, and peri-bronchial tissue throughout both lungs. The latter case was associated with congenital cardiac anomaly including single ventricle. These are unique cases of CPL in Korea of which the diagnosis was established through post-mortem examination. Therefore, the authors report these two cases with primary CPL with a review of the literature.
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Affiliation(s)
- Minseob Eom
- Department of Forensic Medicine, Western District Office, National Institute of Scientific Investigation, Jangseong, Korea
| | - Yoo Duk Choi
- Department of Forensic Medicine, Western District Office, National Institute of Scientific Investigation, Jangseong, Korea
| | - Youn Shin Kim
- Department of Forensic Medicine, Western District Office, National Institute of Scientific Investigation, Jangseong, Korea
| | - Mee-Yon Cho
- Department of Pathology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Soon-Hee Jung
- Department of Pathology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Han Young Lee
- Department of Forensic Medicine, Western District Office, National Institute of Scientific Investigation, Jangseong, Korea
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Bellini C, Boccardo F, Campisi C, Bonioli E. Congenital pulmonary lymphangiectasia. Orphanet J Rare Dis 2006; 1:43. [PMID: 17074089 PMCID: PMC1637094 DOI: 10.1186/1750-1172-1-43] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2006] [Accepted: 10/30/2006] [Indexed: 12/24/2022] Open
Abstract
Congenital pulmonary lymphangiectasia (PL) is a rare developmental disorder involving the lung, and characterized by pulmonary subpleural, interlobar, perivascular and peribronchial lymphatic dilatation. The prevalence is unknown. PL presents at birth with severe respiratory distress, tachypnea and cyanosis, with a very high mortality rate at or within a few hours of birth. Most reported cases are sporadic and the etiology is not completely understood. It has been suggested that PL lymphatic channels of the fetal lung do not undergo the normal regression process at 20 weeks of gestation. Secondary PL may be caused by a cardiac lesion. The diagnostic approach includes complete family and obstetric history, conventional radiologic studies, ultrasound and magnetic resonance studies, lymphoscintigraphy, lung functionality tests, lung biopsy, bronchoscopy, and pleural effusion examination. During the prenatal period, all causes leading to hydrops fetalis should be considered in the diagnosis of PL. Fetal ultrasound evaluation plays a key role in the antenatal diagnosis of PL. At birth, mechanical ventilation and pleural drainage are nearly always necessary to obtain a favorable outcome of respiratory distress. Home supplemental oxygen therapy and symptomatic treatment of recurrent cough and wheeze are often necessary during childhood, sometimes associated with prolonged pleural drainage. Recent advances in intensive neonatal care have changed the previously nearly fatal outcome of PL at birth. Patients affected by PL who survive infancy, present medical problems which are characteristic of chronic lung disease.
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Affiliation(s)
- Carlo Bellini
- Neonatal Intensive Care Unit, Department of Pediatrics, University of Genoa, G. Gaslini Institute, Genoa, Italy
| | - Francesco Boccardo
- Section of Lymphatic Surgery and Microsurgery, Department of Surgery, S. Martino Hospital, University of Genoa, Genoa, Italy
| | - Corradino Campisi
- Section of Lymphatic Surgery and Microsurgery, Department of Surgery, S. Martino Hospital, University of Genoa, Genoa, Italy
| | - Eugenio Bonioli
- Department of Pediatrics, University of Genoa, G. Gaslini Institute, Genoa, Italy
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