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Dhanju G, Goubran A, Kirkpatrick I, Wiebe S, Fogel J. Antenatal diagnosis of bronchopulmonary sequestration: A case report and review of the literature. Radiol Case Rep 2024; 19:604-613. [PMID: 38111561 PMCID: PMC10726340 DOI: 10.1016/j.radcr.2023.10.061] [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: 09/30/2023] [Accepted: 10/26/2023] [Indexed: 12/20/2023] Open
Abstract
Congenital lung malformations are a constellation of pathologies that can be diagnosed antenatally by ultrasound and fetal MRI. Ultrasound is considered the modality of choice for a routine assessment of second-trimester scans worldwide. Bronchopulmonary sequestration (BPS) and congenital pulmonary airway malformation (CPAM) are the 2 most common echogenic chest masses discovered incidentally during routine ultrasound scans in the second trimester. This paper describes BPS and differentiates it from CPAM sonographically in utero. An extensive literature search involving antenatal ultrasound is undertaken to review the most up-to-date understanding of the BPS. Furthermore, a case study at our institution and the literature review will help better describe the salient features of BPS. A 41-year-old female G3P1 visits our department for a routine second-trimester ultrasound. An echogenic lesion with a cystic component is visualized in this scan. Based on the grayscale and color imaging, this complex echogenic lesion was reported as CPAM and was referred to fetal assessment for confirmation. The fetal assessment diagnosed the lesion as BPS because of the pathognomonic feeding vessel from the thoracic aorta. Regardless of the congenital lung mass, any large mass compromising fetal well-being is an indication for intervention. The prognosis of BPS in the absence of fetal hydrops is excellent. A robust collaboration among radiologists, obstetricians, and pediatricians is required for the best outcome for the pregnancy and the neonate.
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Affiliation(s)
- Gurinder Dhanju
- University of Saskatchewan, SK, Canada
- St. Boniface Hospital, Winnipeg, MB, Canada
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Shafiq M, Qadeer T, Tentzeris V, Kastelik J. Rare presentation of pneumothorax in a young woman with underlying congenital pulmonary airway malformation. BMJ Case Rep 2023; 16:e254294. [PMID: 38050398 PMCID: PMC10693894 DOI: 10.1136/bcr-2022-254294] [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] [Accepted: 11/17/2023] [Indexed: 12/06/2023] Open
Abstract
Congenital pulmonary airway malformation (CPAM) is the most common among a rare group of congenital anomalies of the lower respiratory tract. It has variable presentation depending on its subtype and the patient's age. It may lead to respiratory distress in neonates. It can be a particularly challenging diagnosis in children born asymptomatic but present with complications later in life such as haemoptysis, recurrent chest infections, breathlessness and pneumothorax. Prenatal ultrasound, chest X-ray, CT scan and MRI are helpful in making a radiological diagnosis.A woman in her late teens presented with shortness of breath and right pleuritic chest pain. CT's chest showed a number of bullae of varying sizes on the right, including one huge bulla compressing all three lobes. She underwent lung volume reduction surgery via video-assisted thoracoscopy, and the histology specimen confirmed the diagnosis of CPAM type 1.
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Affiliation(s)
- Muhammad Shafiq
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Hull, Kingston upon Hull, UK
- Department of Respiratory Medicine, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
| | - Tariq Qadeer
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Hull, Kingston upon Hull, UK
| | - Vasileios Tentzeris
- Thoracic Surgery, Castle Hill Hospital, Cottingham, East Riding of Yorkshire, UK
| | - Jack Kastelik
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Hull, Kingston upon Hull, UK
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Roshan MP, de Macedo Filho R, Sayegh K. Rare case of bilateral bronchopulmonary sequestration. Radiol Case Rep 2023; 18:3236-3239. [PMID: 37448606 PMCID: PMC10336350 DOI: 10.1016/j.radcr.2023.06.038] [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: 04/01/2023] [Revised: 05/28/2023] [Accepted: 06/18/2023] [Indexed: 07/15/2023] Open
Abstract
Pulmonary sequestration is a rare congenital bronchopulmonary malformation with an estimated incidence of less than 6%. It is described as the abnormal formation of nonfunctional lung tissue that receives its blood supply from systemic circulation rather than the bronchial tree. Most are unilateral, while a miniscule proportion is bilateral. Delayed diagnosis can result in recurrent pneumonia, failure to thrive, regular hospital visits, morbidity and even fatality. Thus, it is important to raise awareness of this condition. Herein, we present a case of a 42-year-old patient with bilateral pulmonary sequestration (BPS) on a triple rule out CT angiography (TRO-CTA).
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Affiliation(s)
- Mona P. Roshan
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Robson de Macedo Filho
- Baptist Health of South Florida and Radiology Associates of South Florida, 8900 N Kendall Dr, Miami, FL, 33176 USA
| | - Karl Sayegh
- Baptist Health of South Florida and Radiology Associates of South Florida, 8900 N Kendall Dr, Miami, FL, 33176 USA
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King A, Olutoye OO, Lee TC, Keswani SG. Surgical Management of Congenital Lung Malformations. Neoreviews 2023; 24:e84-e96. [PMID: 36720690 DOI: 10.1542/neo.24-2-e84] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Congenital lung malformations (CLMs) are commonly diagnosed prenatal lesions with varied natural history. Prenatal diagnosis and monitoring help to guide fetal interventions, delivery planning, and need for urgent perinatal surgical interventions. All prenatally diagnosed CLMs should be evaluated postnatally, typically with cross-sectional imaging, because many lesions persist despite the appearance of complete 'regression' in utero. Management of CLMs in asymptomatic infants weighs the surgical and anesthetic risk of prophylactic resection against the risk of expectant management, including the possibility of infection, malignant degeneration, and more complicated surgical resection later with loss of compensatory lung growth.
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Affiliation(s)
- Alice King
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.,Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX.,Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX
| | - Oluyinka O Olutoye
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX
| | - Timothy C Lee
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.,Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX.,Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX
| | - Sundeep G Keswani
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.,Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX.,Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX
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Gupta A, Chetty G, Hopkinson D, Rao J, Chetty G. Right upper lobe pulmonary sequestration masquerading clinically and radiologically as malignancy: a case report. J Surg Case Rep 2023; 2023:rjad022. [PMID: 36741081 PMCID: PMC9890208 DOI: 10.1093/jscr/rjad022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/06/2022] [Indexed: 02/04/2023] Open
Abstract
Bronchopulmonary sequestration is a rare disease in which a non-functional region of pulmonary tissue receives an aberrant vascular supply and lacks normal communication with the tracheobronchial tree. We present the case of a 30-year-old female with a primary complaint of unexplained weight loss and no other additional signs or symptoms. In view of this, computed tomography imaging was ordered, showing a 33HU mass in the right upper lobe. A specialist radiologist reviewed the images and concluded that the most likely differentials were mediastinal lymphoma or thymic malignancy. Video-assisted thoracoscopic surgery was performed, when it was seen that no malignancy was present, but rather a bronchopulmonary sequestration. Histology confirmed the diagnosis; the patient fared well post-operatively. Bronchopulmonary sequestration is a rare pathology, with most cases occurring in the lower lung lobes. This case is highly atypical, due to the lack of clinical features and the lesion radiologically mimicking the appearance of malignancy.
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Affiliation(s)
- Ankit Gupta
- School of Medicine, Worsley Building, University of Leeds, Woodhouse, Leeds, LS2 9JT, UK
| | - Gavin Chetty
- Northern General Hospital, Herries Road, Sheffield S5 7AU, UK
| | - David Hopkinson
- Northern General Hospital, Herries Road, Sheffield S5 7AU, UK
| | - Jagan Rao
- Northern General Hospital, Herries Road, Sheffield S5 7AU, UK
| | - Govind Chetty
- Correspondence address. Northern General Hospital, Herries Road, Sheffield S5 7AU, UK. Tel: (+44)114 2714833; Fax: (+44)114 2610350; E-mail:
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