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Zeng H, Ali S, Sebastian A, Ramos-Medero AS, Albert I, Dean C, Liu A. CPLANE protein INTU regulates growth and patterning of the mouse lungs through cilia-dependent Hh signaling. Dev Biol 2024; 515:92-101. [PMID: 39029571 DOI: 10.1016/j.ydbio.2024.07.006] [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: 01/15/2024] [Revised: 07/01/2024] [Accepted: 07/16/2024] [Indexed: 07/21/2024]
Abstract
Congenital lung malformations are fatal at birth in their severe forms. Prevention and early intervention of these birth defects require a comprehensive understanding of the molecular mechanisms of lung development. We find that the loss of inturned (Intu), a cilia and planar polarity effector gene, severely disrupts growth and branching morphogenesis of the mouse embryonic lungs. Consistent with our previous results indicating an important role for Intu in ciliogenesis and hedgehog (Hh) signaling, we find greatly reduced number of primary cilia in both the epithelial and mesenchymal tissues of the lungs. We also find significantly reduced expression of Gli1 and Ptch1, direct targets of Hh signaling, suggesting disruption of cilia-dependent Hh signaling in Intu mutant lungs. An agonist of the Hh pathway activator, smoothened, increases Hh target gene expression and tubulogenesis in explanted wild type, but not Intu mutant, lungs, suggesting impaired Hh signaling response underlying lung morphogenetic defects in Intu mutants. Furthermore, removing both Gli2 and Intu completely abolishes branching morphogenesis of the lung, strongly supporting a mechanism by which Intu regulates lung growth and patterning through cilia-dependent Hh signaling. Moreover, a transcriptomics analysis identifies around 200 differentially expressed genes (DEGs) in Intu mutant lungs, including known Hh target genes Gli1, Ptch1/2 and Hhip. Genes involved in muscle differentiation and function are highly enriched among the DEGs, consistent with an important role of Hh signaling in airway smooth muscle differentiation. In addition, we find that the difference in gene expression between the left and right lungs diminishes in Intu mutants, suggesting an important role of Intu in asymmetrical growth and patterning of the mouse lungs.
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Affiliation(s)
- Huiqing Zeng
- Department of Biology, Eberly College of Science, Huck Institute of Life Sciences, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Shimaa Ali
- Department of Biology, Eberly College of Science, Huck Institute of Life Sciences, The Pennsylvania State University, University Park, PA, 16802, USA; Faculty of Veterinary Medicine, Sohag University, Sohag, 82524, Egypt
| | - Aswathy Sebastian
- Department of Biochemistry and Molecular Biology, Eberly College of Science, Huck Institute of Life Sciences, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Adriana Sophia Ramos-Medero
- Department of Biology, Eberly College of Science, Huck Institute of Life Sciences, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Istvan Albert
- Department of Biochemistry and Molecular Biology, Eberly College of Science, Huck Institute of Life Sciences, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Charlotte Dean
- National Heart and Lung Institute, Imperial College London, London, SW7 2AZ, UK
| | - Aimin Liu
- Department of Biology, Eberly College of Science, Huck Institute of Life Sciences, The Pennsylvania State University, University Park, PA, 16802, USA.
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2
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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.
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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
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3
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Krisem M, Phongnarudech T, Hengriprasopchoke S, Thanapongsatorn P. Lingular intralobar pulmonary sequestration supplied by the left inferior phrenic artery arising from the left gastric artery - A case report and literature review. Radiol Case Rep 2024; 19:839-843. [PMID: 38188943 PMCID: PMC10770495 DOI: 10.1016/j.radcr.2023.11.047] [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: 10/21/2023] [Accepted: 11/17/2023] [Indexed: 01/09/2024] Open
Abstract
Pulmonary sequestration is characterized by a nonfunctional mass of lung tissue with an aberrant blood supply. Intralobar pulmonary sequestration (IPS) typically affects lower lung lobes and receives its blood supply from systemic arteries. Here, we present a unique case of a 51-year-old woman presented with recurrent nonmassive hemoptysis. Contrast-enhanced computed tomography angiography (CTA) of the chest showed uniform consolidation in the inferior lingular segment of the left upper lobe. Maximal intensity projection (MIP) and three-dimensional volume rendering (3D-VR) showed the affected area's blood supply from unusual arterial branches originating from the left inferior phrenic artery arising from the left gastric artery, consistent with IPS. A multidisciplinary approach utilized endovascular intervention (coil embolization) before successful surgical resection. Detecting IPS in unusual sites, like the lingular region, poses a diagnostic challenge. Clinicians and radiologists may not initially consider this diagnosis when evaluating patients with respiratory symptoms or incidental imaging findings. A comprehensive grasp of their anatomy and vascular variations is vital for precise diagnosis and effective treatment planning.
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Affiliation(s)
- Massupa Krisem
- Department of Radiology, Faculty of Medicine, Thammasat University Hospital, Pathum Thani, Thailand
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand
| | - Thanyakamol Phongnarudech
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand
| | - Suthinee Hengriprasopchoke
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand
| | - Peerapat Thanapongsatorn
- Department of Medicine, Faculty of Medicine, Thammasat University Hospital, Pathum Thani, Thailand
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4
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Kumbasar U, Uysal S, Doğan R. Congenital pulmonary malformations. TURK GOGUS KALP DAMAR CERRAHISI DERGISI 2024; 32:S60-S72. [PMID: 38584784 PMCID: PMC10995677 DOI: 10.5606/tgkdc.dergisi.2024.25713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/11/2023] [Indexed: 04/09/2024]
Abstract
There are many congenital anomalies of the lung, some of which have no clinical symptoms and are detected incidentally, while others, particularly in the neonatal and infant period, are recognized by their typical signs, symptoms, and radiological appearance. Some congenital lung anomalies are so important that they can cause the death of the patient if not diagnosed and treated early. Classification of congenital lung anomalies is difficult since these anomalies may be related to the airway, arterial and venous vascular system, pulmonary parenchyma, and primitive anterior intestinal anomalies from which the lung originates, and some anomalies may have several etiologic origins. In this review, all subgroups of congenital pulmonary malformations will be discussed.
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Affiliation(s)
- Ulaş Kumbasar
- Department of Thoracic Surgery, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Serkan Uysal
- Department of Thoracic Surgery, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Rıza Doğan
- Department of Thoracic Surgery, Hacettepe University Faculty of Medicine, Ankara, Türkiye
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Alsararatee HH, Munje M. Unexpected pulmonary sequestration in a pregnant patient. BMJ Case Rep 2023; 16:e256568. [PMID: 38114298 DOI: 10.1136/bcr-2023-256568] [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] [Indexed: 12/21/2023] Open
Abstract
A pregnant woman in her early 30s, at 20 weeks of gestational age, presented with recurrent haemoptysis, pleuritic chest pain and a productive cough of 6 months duration. She underwent CT pulmonary angiogram which demonstrated right pulmonary sequestration and right-sided consolidation. Pre-existing pulmonary comorbidities such as chronic inflammation, structural abnormalities or weakened blood vessels within the lungs can encourage the growth of abnormal blood vessels. During pregnancy, these dynamics can be further aggravated by increasing cardiac output to promote blood flow to the placenta and increasing oxygen delivery to the developing foetus. These changes likely cause increased blood flow to the pulmonary sequestration, resulting in haemoptysis. The patient was treated conservatively for community-acquired pneumonia with a course of oral amoxicillin 500 mg three times a day for 5 days, and she is doing well on follow-up.
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Affiliation(s)
- Hasan Hazim Alsararatee
- Acute Medicine/ SDEC, Northampton General Hospital NHS Trust, Northampton, Northamptonshire, UK
| | - Muhit Munje
- Acute Medicine/ SDEC, Northampton General Hospital NHS Trust, Northampton, Northamptonshire, UK
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Hamdar H, Nahle AA, Jawad A, Sikaria A, Alisame K, Abbas N. A unique case of intralobar pulmonary sequestration in an elderly patient: A case report. Respir Med Case Rep 2023; 46:101934. [PMID: 37920362 PMCID: PMC10618754 DOI: 10.1016/j.rmcr.2023.101934] [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: 07/04/2023] [Accepted: 10/14/2023] [Indexed: 11/04/2023] Open
Abstract
Pulmonary sequestration (PS) is a rare congenital anomaly characterized by non-functional lung tissue receiving blood supply from an abnormal source. PS is typically diagnosed in young individuals but is uncommon in the elderly. This abstract describes a case of PS in a 62-year-old male patient presenting with recurrent fever, chronic cough, and difficulty breathing. Imaging revealed abnormal lung tissue disconnected from the bronchial tree, with blood supply from the descending thoracic aorta. Surgical intervention successfully treated the condition. The case emphasizes the need to consider PS as a possible diagnosis, even in older patients, and suggests further research into its possible etiologies.
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Affiliation(s)
| | | | - Ali Jawad
- Faculty of Medicine, Damascus University, Syria
| | | | - Komai Alisame
- MD in Thoracic Surgery, Alassad University Hospital, Damascus, Syria
| | - Nizar Abbas
- PhD in Thoracic Surgery, Head Department in Alassad University Hospital, Damascus, Syria
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Marinucci BT, Menna C, Scanagatta P, Fiorelli S, Tiracorrendo M, Naldi G, Inserra A, Macchini F, Rendina EA, Ibrahim M. Do More with Less? Lobectomy vs. Segmentectomy for Patients with Congenital Pulmonary Malformations. J Clin Med 2023; 12:5237. [PMID: 37629279 PMCID: PMC10455964 DOI: 10.3390/jcm12165237] [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: 07/06/2023] [Revised: 07/29/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Congenital Pulmonary Malformations (CPMs) are rare benign lesions potentially causing infective complications and/or malignant transformation, requiring surgery even when asymptomatic. CPMs are rare in adulthood but potentially detected at any age. There is not a consensus on the correct extent of resection in both adults and paediatrics. This retrospective multicentric study aims to identify the appropriate surgical resection to prevent the recurrence of the related respiratory symptoms. METHODS Between 2010 and 2020, a total of 96 patients (adults and pediatrics) underwent surgery for CPMs in 4 centers. A 2:1 propensity score matching (considering sex and lesion side) was performed, identifying 2 groups: 50 patients underwent lobectomy (group A) and 25 sub-lobar resections (group B). Clinical and histopathological characteristics, early and late complications, and symptom recurrence were retrospectively analyzed and compared between the two groups by univariate and multivariate analysis. RESULTS Patients who underwent lobectomy had a statistically significant lower rate of recurrence (4% vs. 24% of group B, p = 0.014) and a lower rate of intraoperative complications (p = 0.014). Logistic regression identified sub-lobar resection (p = 0.040), intra- and post-operative complications (p = 0.105 and 0.022),and associated developed neoplasm (p = 0.062) as possible risk factors for symptom recurrence after surgery. CONCLUSIONS Pulmonary lobectomy seems to be the most effective surgical treatment for CPMs, guaranteeing the stable remission of symptoms and a lower rate of intra- and postoperative complications. To our knowledge, this is one of the largest studies comparing lobectomy and sub-lobar resections in patients affected by CPMs, considering the low incidence worldwide.
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Affiliation(s)
- Beatrice Trabalza Marinucci
- Thoracic Surgery Sant’Andrea Hospital, La Sapienza University, 00186 Rome, Italy; (C.M.); (M.T.); (E.A.R.); (M.I.)
| | - Cecilia Menna
- Thoracic Surgery Sant’Andrea Hospital, La Sapienza University, 00186 Rome, Italy; (C.M.); (M.T.); (E.A.R.); (M.I.)
| | - Paolo Scanagatta
- Thoracic Surgery—Morelli Hospital, ASST Valtellina e Alto Lario, 23100 Sondalo, Italy; (P.S.); (G.N.)
| | - Silvia Fiorelli
- Anesthesiology and Intensive Care, Sant’Andrea Hospital, La Sapienza University, 00186 Rome, Italy;
| | - Matteo Tiracorrendo
- Thoracic Surgery Sant’Andrea Hospital, La Sapienza University, 00186 Rome, Italy; (C.M.); (M.T.); (E.A.R.); (M.I.)
| | - Giuseppe Naldi
- Thoracic Surgery—Morelli Hospital, ASST Valtellina e Alto Lario, 23100 Sondalo, Italy; (P.S.); (G.N.)
| | - Alessandro Inserra
- General and Thoracic Surgery—Bambino Gesù Children’s Research Hospital IRCCS, 00165 Rome, Italy;
| | - Francesco Macchini
- Paediatric Surgery—Niguarda Hospital, ASST Grande Ospedale Niguarda, 20162 Milan, Italy;
| | - Erino Angelo Rendina
- Thoracic Surgery Sant’Andrea Hospital, La Sapienza University, 00186 Rome, Italy; (C.M.); (M.T.); (E.A.R.); (M.I.)
| | - Mohsen Ibrahim
- Thoracic Surgery Sant’Andrea Hospital, La Sapienza University, 00186 Rome, Italy; (C.M.); (M.T.); (E.A.R.); (M.I.)
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Bakhuis W, Kersten CM, Sadeghi AH, Mank QJ, Wijnen RMH, Ciet P, Bogers AJJC, Schnater JM, Mahtab EAF. Preoperative visualization of congenital lung abnormalities: hybridizing artificial intelligence and virtual reality. Eur J Cardiothorac Surg 2022; 63:ezad014. [PMID: 36645240 PMCID: PMC10481780 DOI: 10.1093/ejcts/ezad014] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/16/2022] [Accepted: 01/15/2023] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES When surgical resection is indicated for a congenital lung abnormality (CLA), lobectomy is often preferred over segmentectomy, mostly because the latter is associated with more residual disease. Presumably, this occurs in children because sublobar surgery often does not adhere to anatomical borders (wedge resection instead of segmentectomy), thus increasing the risk of residual disease. This study investigated the feasibility of identifying eligible cases for anatomical segmentectomy by combining virtual reality (VR) and artificial intelligence (AI). METHODS Semi-automated segmentation of bronchovascular structures and lesions were visualized with VR and AI technology. Two specialists independently evaluated via a questionnaire the informative value of regular computed tomography versus three-dimensional (3D) VR images. RESULTS Five asymptomatic, non-operated cases were selected. Bronchovascular segmentation, volume calculation and image visualization in the VR environment were successful in all cases. Based on the computed tomography images, assignment of the CLA lesion to specific lung segments matched between the consulted specialists in only 1 out of the cases. Based on the three 3D VR images, however, the localization matched in 3 of the 5 cases. If the patients would have been operated, adding the 3D VR tool to the preoperative workup would have resulted in changing the surgical strategy (i.e. lobectomy versus segmentectomy) in 4 cases. CONCLUSIONS This study demonstrated the technical feasibility of a hybridized AI-VR visualization of segment-level lung anatomy in patients with CLA. Further exploration of the value of 3D VR in identifying eligible cases for anatomical segmentectomy is therefore warranted.
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Affiliation(s)
- Wouter Bakhuis
- Department of Cardiothoracic Surgery, Thoraxcenter, Erasmus MC, Rotterdam, Netherlands
| | - Casper M Kersten
- Department of Pediatric Surgery, Erasmus MC—Sophia Children’s Hospital, Rotterdam, Netherlands
| | - Amir H Sadeghi
- Department of Cardiothoracic Surgery, Thoraxcenter, Erasmus MC, Rotterdam, Netherlands
| | - Quinten J Mank
- Department of Cardiothoracic Surgery, Thoraxcenter, Erasmus MC, Rotterdam, Netherlands
- Technical Medicine, Delft University of Technology, Delft, Netherlands
| | - René M H Wijnen
- Department of Pediatric Surgery, Erasmus MC—Sophia Children’s Hospital, Rotterdam, Netherlands
| | - Pierluigi Ciet
- Department of Radiology and Nuclear Medicine, Erasmus MC Sophia Children’s Hospital, Rotterdam, Netherlands
| | - Ad J J C Bogers
- Department of Cardiothoracic Surgery, Thoraxcenter, Erasmus MC, Rotterdam, Netherlands
| | - J Marco Schnater
- Department of Pediatric Surgery, Erasmus MC—Sophia Children’s Hospital, Rotterdam, Netherlands
| | - Edris A F Mahtab
- Department of Cardiothoracic Surgery, Thoraxcenter, Erasmus MC, Rotterdam, Netherlands
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Congenital Lung Malformations: Clinical and Functional Respiratory Outcomes after Surgery. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121881. [PMID: 36553325 PMCID: PMC9777274 DOI: 10.3390/children9121881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/14/2022] [Accepted: 11/25/2022] [Indexed: 12/03/2022]
Abstract
Congenital lung malformations (CLMs) involve anomalies of the lungs and respiratory tree such as congenital pulmonary airway malformation (CPAM), pulmonary sequestration (PS), bronchogenic cysts, congenital lobar emphysema, and bronchial atresia (BA). Although symptomatic lesions require surgical resection, the appropriateness of surgery for patients with asymptomatic malformations is a matter of ongoing debate. Limited data are available concerning the long-term follow-up of affected subjects. In this study, we sought to evaluate the long-term clinical and functional respiratory outcomes in children with CLMs who underwent surgical resection. We carried out a retrospective analysis of 77 children with CLMs who underwent pulmonary resection with at least one year of follow-up. The most common diagnoses were CPAM (50.65%), hybrid lesions (25.97%), lobar emphysema (11.69%), and PS (5.19%). The most common surgical approaches were lobectomy (61.3%), segmentectomy (10.7%), and pneumonectomy (5.3%). Acute post-surgery complications occurred in 31.2% of children. In addition, 73.7% experienced long-term complications, and we found no correlation between the presence of these complications and the sex of the patients, their age at time of surgery, the type of surgery undergone, the presence of symptoms prior to intervention, or acute complications after surgery. Pulmonary function tests revealed FEV1 Z-scores of <−2 SDs in 16 patients, and we found a significant correlation between pneumonectomy and the development of lung function deficit (p = 0.031). In conclusion, clinical and functional respiratory complications may occur in children with CLMs who undergo surgical resection. Long-term monitoring is needed to improve the management of asymptomatic patients.
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10
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Sintim-Damoa A, Cohen HL. Fetal imaging of congenital lung lesions with postnatal correlation. Pediatr Radiol 2022; 52:1921-1934. [PMID: 36002772 DOI: 10.1007/s00247-022-05465-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 06/27/2022] [Accepted: 07/21/2022] [Indexed: 11/30/2022]
Abstract
Congenital lung lesions are a rare group of developmental pulmonary abnormalities that are often first identified prenatally on routine second-trimester US. Congenital pulmonary airway malformation (CPAM) is the most common anomaly while others include bronchopulmonary sequestration, congenital lobar overinflation, bronchogenic cyst and bronchial atresia. Clinical presentation is highly variable, ranging from apparent in utero resolution to severe mass effect with resultant hydrops fetalis and fetal demise. Differentiation among these lesions can be challenging because overlapping imaging features are often present. The roles of the radiologist are to identify key imaging findings that help in diagnosing congenital lung lesions and to recognize any ominous features that might require prenatal or perinatal intervention. High-resolution US and complementary rapid-acquisition fetal MRI provide valuable information necessary for lesion characterization. Postnatal US and CT angiography are helpful for lesion evaluation and for possible surgical planning. This article reviews the embryology of the lungs, the normal prenatal imaging appearance of the thorax and its contents, and the prenatal and neonatal imaging characteristics, prognosis and management of various congenital lung lesions.
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Affiliation(s)
- Akosua Sintim-Damoa
- Department of Radiology, LeBonheur Children's Hospital, University of Tennessee Health Science Center, 848 Adams Ave., Memphis, TN, 38103, USA.
| | - Harris L Cohen
- Department of Radiology, LeBonheur Children's Hospital, University of Tennessee Health Science Center, 848 Adams Ave., Memphis, TN, 38103, USA
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Avena-Zampieri CL, Hutter J, Rutherford M, Milan A, Hall M, Egloff A, Lloyd DFA, Nanda S, Greenough A, Story L. Assessment of the fetal lungs in utero. Am J Obstet Gynecol MFM 2022; 4:100693. [PMID: 35858660 PMCID: PMC9811184 DOI: 10.1016/j.ajogmf.2022.100693] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 07/12/2022] [Accepted: 07/12/2022] [Indexed: 01/07/2023]
Abstract
Antenatal diagnosis of abnormal pulmonary development has improved significantly over recent years because of progress in imaging techniques. Two-dimensional ultrasound is the mainstay of investigation of pulmonary pathology during pregnancy, providing good prognostication in conditions such as congenital diaphragmatic hernia; however, it is less validated in other high-risk groups such as those with congenital pulmonary airway malformation or preterm premature rupture of membranes. Three-dimensional assessment of lung volume and size is now possible using ultrasound or magnetic resonance imaging; however, the use of these techniques is still limited because of unpredictable fetal motion, and such tools have also been inadequately validated in high-risk populations other than those with congenital diaphragmatic hernia. The advent of advanced, functional magnetic resonance imaging techniques such as diffusion and T2* imaging, and the development of postprocessing pipelines that facilitate motion correction, have enabled not only more accurate evaluation of pulmonary size, but also assessment of tissue microstructure and perfusion. In the future, fetal magnetic resonance imaging may have an increasing role in the prognostication of pulmonary abnormalities and in monitoring current and future antenatal therapies to enhance lung development. This review aims to examine the current imaging methods available for assessment of antenatal lung development and to outline possible future directions.
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Affiliation(s)
- Carla L Avena-Zampieri
- Department of Women and Children's Health, King's College London, London, United Kingdom; Centre for the Developing Brain, King's College London, London, United Kingdom
| | - Jana Hutter
- Centre for the Developing Brain, King's College London, London, United Kingdom
| | - Mary Rutherford
- Centre for the Developing Brain, King's College London, London, United Kingdom
| | - Anna Milan
- Neonatal Unit, Guy's and St Thomas' National Health Service Foundation Trust, London, United Kingdom
| | - Megan Hall
- Department of Women and Children's Health, King's College London, London, United Kingdom; Centre for the Developing Brain, King's College London, London, United Kingdom
| | - Alexia Egloff
- Centre for the Developing Brain, King's College London, London, United Kingdom
| | - David F A Lloyd
- Centre for the Developing Brain, King's College London, London, United Kingdom
| | - Surabhi Nanda
- Fetal Medicine Unit, Guy's and St Thomas' National Health Service Foundation Trust, London, United Kingdom
| | - Anne Greenough
- Department of Women and Children's Health, King's College London, London, United Kingdom; Neonatal Unit, King's College Hospital, London, United Kingdom; Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, London, United Kingdom; National Institute for Health and Care Research Biomedical Research Centre, Guy's & St Thomas National Health Service Foundation Trust and King's College London, London, United Kingdom
| | - Lisa Story
- Department of Women and Children's Health, King's College London, London, United Kingdom; Centre for the Developing Brain, King's College London, London, United Kingdom; Fetal Medicine Unit, Guy's and St Thomas' National Health Service Foundation Trust, London, United Kingdom.
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12
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Anwar M. Hemothorax From an Anomalous Bronchial Artery Bleed in an Infected Intralobar Pulmonary Sequestration. Cureus 2022; 14:e28656. [PMID: 36196329 PMCID: PMC9525033 DOI: 10.7759/cureus.28656] [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] [Accepted: 08/31/2022] [Indexed: 11/06/2022] Open
Abstract
Pulmonary sequestration is a rare congenital malformation. It represents 0.15-6.4% of all congenital pulmonary malformations. It is characterized by non-functional, dysplastic mass of lung tissue that is not in communication with the normal tracheobronchial tree and is associated with a systemic arterial supply. We report a young gentleman in his mid-thirties who presented with community-acquired pneumonia from an infected intralobar pulmonary sequestration which subsequently developed a hemothorax from an anomalous bronchial artery bleed.
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13
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Klinkner DB, Atwell T, Telles Abrao Trad A, Callstrom MR, Qureshi MY, Bendel Stenzel E, Schenone M, Ruano R. Innovative fetal therapy for a giant congenital pulmonary airway malformation with hydrops. Fetal Diagn Ther 2022; 49:250-255. [DOI: 10.1159/000521690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 12/23/2021] [Indexed: 11/19/2022]
Abstract
Introduction: Congenital pulmonary airway malformations (CPAM) complicated by hydrops portends significant morbidity and mortality, with fetal survival estimates less than 10%.
Case Presentation: We report successful use of ultrasound-guided radio-frequency ablation at 21 weeks gestation in a hydropic fetus with CPAM, with subsequent resolution of hydrops. 32 week MRI noted persistent mediastinal shift, and US at 36 weeks and 5days noted polyhydramnios. Maternal gestational hypertension prompted delivery at 37 weeks, with cesarean section performed after failed trial of labor. The infant required CPAP at 100% and weaned to 21%. Tachypnea persisted, and chest CT on DOL2 demonstrated multiple large cysts in the right lower lobe with anterior pneumothorax. On DOL3 she successfully underwent a thoracoscopic right lower lobectomy. Adhesions to the chest wall and rib abnormalities were noted. She was extubated to CPAP at the conclusion of the procedure. She was able to wean to 21% on POD2, and transitioned to oral feeds. Her chest tube was removed with resultant ex vacuo pneumothorax noted. She remained asymptomatic and was discharged home on room air POD11. Pathology confirmed a type 1 CPAM.
Conclusion: In utero radiofrequency ablation may be an adjunct to the management of large CPAM.
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Surgery versus conservative management in congenital lobar emphysema: follow up and indicators for surgery. Pediatr Surg Int 2022; 38:559-568. [PMID: 35212777 DOI: 10.1007/s00383-022-05086-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/10/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Congenital lobar emphysema (CLE), a rare developmental lung malformation, involves the hyperaeration of one or more lung lobes caused by partial obstruction and occurs at a rate of 1/20,000-30,000 live births. Here, we aimed to retrospectively examine the clinical, radiological, and bronchoscopy findings of patients with CLE who were diagnosed and treated by surgical or non-surgical (conservative) approaches at our center and compared our results with those in the literature. METHODS We examined the clinical, radiological, and bronchoscopy findings of 20 patients with CLE aged 0-18 years at our center between 2013 and 2020. In addition, we examined the symptoms and findings recorded during the patients' follow-up in this retrospective descriptive study. RESULTS The median age of 20 patients with CLE at diagnosis was 3.2 years (range 1 day-17 years). Respiratory distress and mediastinal shift were more prominent in patients who underwent surgery, and they were diagnosed at an earlier age compared with patients who were followed up conservatively (p = 0.001, 0.049, 0.001, respectively). Neither the pulmonary lobe involvement nor the bronchoscopy findings were found to be indicative of surgery. DISCUSSION We observed that respiratory distress and mediastinal shift were more prominent in patients with a diagnosis of CLE who underwent surgery compared with patients who were conservatively followed up. Moreover, we observed that those who underwent surgery were diagnosed with CLE at an earlier age. In line with the literature, the pulmonary symptoms and CLE-related imaging findings in our study were reduced during conservative follow-up.
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15
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Singh V, Shoor G, Acharya SK, Srivastava S. Spectrum of congenital lung and foregut malformations: scope for awareness and prompt management—a case series. Indian J Thorac Cardiovasc Surg 2022; 38:307-311. [PMID: 35529000 PMCID: PMC9023626 DOI: 10.1007/s12055-021-01300-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/05/2021] [Accepted: 11/08/2021] [Indexed: 10/19/2022] Open
Abstract
Congenital lung and foregut malformations have been described in literature, but most articles are from the Western world. There are a separate set of problems which are faced in our country especially with the misdiagnosis of these problems which has not so much been addressed in writing. We retrospectively reviewed records of all patients with above thoracic lesions treated at a tertiary care hospital in Delhi from March 2017 to December 2019. Twenty patients were found. Eight of 20 patients were detected antenatally but none monitored serially. Age at presentation ranged from 5 days to 18 months. Eight patients presented with respiratory distress at birth. Three of these were congenital lobar emphysema wrongly diagnosed as pneumothorax and brought with intercostal drainage tube inserted. Eight suffered from pneumonia, 4 of which had history of previous hospital admission but undetected congenital pathology. All underwent surgery and had good outcome. There was radiological evidence of compensatory lung growth in all patients at 6 months follow-up. Thus, we conclude that the antenatal detection of congenital lung and foregut malformations may have increased but proper serial monitoring is still missing. There is scope of increasing index of suspicion for these lesions among pediatricians and surgeons. With modern-day safe anesthesia, proactive resection of congenital lung and foregut malformations is associated with good outcome. Delaying treatment predisposes the child to infective complications and makes surgery difficult.
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Pelizzo G, Costanzo S, Roveri M, Lanfranchi G, Vertemati M, Milani P, Zuccotti G, Cassin S, Panfili S, Rizzetto F, Campari A, Camporesi A, Calcaterra V. Developing Virtual Reality Head Mounted Display (HMD) Set-Up for Thoracoscopic Surgery of Complex Congenital Lung MalFormations in Children. CHILDREN (BASEL, SWITZERLAND) 2022; 9:50. [PMID: 35053675 PMCID: PMC8774663 DOI: 10.3390/children9010050] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/20/2021] [Accepted: 12/31/2021] [Indexed: 11/19/2022]
Abstract
Video assisted thoracoscopic surgery (VATS) has been adopted in pediatric age for the treatment of congenital lung malformations (CLM). The success of VATS in pediatrics largely depends on the surgeon's skill ability to understand the airways, vascular system and lung parenchyma anatomy in CLM. In the last years, virtual reality (VR) and 3-dimensional (3D) printing of organ models and VR head mounted display (HMD) technologies have been introduced for completion of preoperative planning in adult patients. To date no reports about the use of VR HMD technologies in a pediatric setting are available. The aim of this report is to introduce a VR HMD model in VATS procedure to improve the quality of care in children with CLM. VR HMD set-up for planning thoracoscopic surgery was performed in a series of pediatric patients with diagnosis of CLM. The preoperative VR HMD evaluation allowed a navigation into the malformation with the aim to explore, interact, and make the surgeon more confident and skilled to answer to the traps. A development of surgical simulations models and teaching program dedicated to education and training in pediatric VATS is suitable among the pediatric surgery community. Further studies should demonstrate all the benefits of such technology in pediatric patients submitted to VATS procedure.
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Affiliation(s)
- Gloria Pelizzo
- Pediatric Surgery Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (S.C.); (M.R.); (G.L.)
- Department of Biomedical and Clinical Science “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (M.V.); (G.Z.); (S.C.); (S.P.)
| | - Sara Costanzo
- Pediatric Surgery Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (S.C.); (M.R.); (G.L.)
| | - Margherita Roveri
- Pediatric Surgery Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (S.C.); (M.R.); (G.L.)
| | - Giulia Lanfranchi
- Pediatric Surgery Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (S.C.); (M.R.); (G.L.)
| | - Maurizio Vertemati
- Department of Biomedical and Clinical Science “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (M.V.); (G.Z.); (S.C.); (S.P.)
- CIMaINa (Interdisciplinary Centre for Nanostructured Materials and Interfaces), University of Milano, 20133 Milan, Italy;
| | - Paolo Milani
- CIMaINa (Interdisciplinary Centre for Nanostructured Materials and Interfaces), University of Milano, 20133 Milan, Italy;
- Department of Physics “Aldo Pontremoli”, University of Milano, 20157 Milan, Italy
| | - Gianvincenzo Zuccotti
- Department of Biomedical and Clinical Science “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (M.V.); (G.Z.); (S.C.); (S.P.)
- Pediatric Department, Children’s Hospital “Vittore Buzzi”, 20154 Milan, Italy;
| | - Simone Cassin
- Department of Biomedical and Clinical Science “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (M.V.); (G.Z.); (S.C.); (S.P.)
| | - Sebastiano Panfili
- Department of Biomedical and Clinical Science “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (M.V.); (G.Z.); (S.C.); (S.P.)
| | - Francesco Rizzetto
- Department of Radiology, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy;
- Postgraduate School of Diagnostic and Interventional Radiology, University of Milano, 20157 Milan, Italy
| | - Alessandro Campari
- Pediatric Radiology and Neuroradiology Unit, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy;
| | - Anna Camporesi
- Division of Pediatric Anesthesia and Intensive Care Unit, Department of Pediatrics, Children’s Hospital Vittore Buzzi, 20154 Milan, Italy;
| | - Valeria Calcaterra
- Pediatric Department, Children’s Hospital “Vittore Buzzi”, 20154 Milan, Italy;
- Pediatrics and Adolescentology Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
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Ogunleye E, Olusoji O, Fajolu I, Iwuchukwu P. Ten years experience in surgical management of congenital lung malformations: A prospective, cross sectional study. JOURNAL OF CLINICAL SCIENCES 2022. [DOI: 10.4103/jcls.jcls_53_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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18
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Bhende VV, Sharma TS, Majmudar HP, Pathan SR, Chitaliya A, Kumar A, Trivedi BY. A Novel Approach to Facilitate an Ideal Surgical Correction of Congenital Lobar Emphysema by Using Neonatal Ultrathin Bronchoscopy-Guided Endo-Bronchial Block. Cureus 2021; 13:e17901. [PMID: 34660097 PMCID: PMC8509106 DOI: 10.7759/cureus.17901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2021] [Indexed: 11/28/2022] Open
Abstract
This is a case report of a child who had acyanotic congenital heart disease - ventricular septal defect (VSD) and a patent ductus arteriosus (PDA) with severe pulmonary arterial hypertension. The child underwent open-heart surgery - VSD closure with PDA ligation - and six months later was re-admitted for congenital lobar emphysema of the right middle lobe. He underwent successful right middle lobectomy of the lung six months after cardiac surgery under a one-lung ventilation technique in which application of fiber-optic bronchoscope made the surgery safer and more suitable.
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Affiliation(s)
- Vishal V Bhende
- Pediatric Cardiac Surgery, Bhanubhai and Madhuben Patel Cardiac Centre, Shree Krishna Hospital, Anand, IND
| | - Tanishq S Sharma
- Pediatric Cardiac Surgery, Bhanubhai and Madhuben Patel Cardiac Centre, Shree Krishna Hospital, Anand, IND
| | - Hardil P Majmudar
- Pediatrics, Bhanubhai and Madhuben Patel Cardiac Centre, Shree Krishna Hospital, Anand, IND
| | - Sohilkhan R Pathan
- Clinical Research, Bhanubhai and Madhuben Patel Cardiac Centre, Shree Krishna Hospital, Anand, IND
| | - Amit Chitaliya
- Pediatric and Neonatal, Care Institute of Medical Sciences (CIMS) Hospital, Ahmedabad, IND
| | - Amit Kumar
- Pediatric Cardiology, Bhanubhai and Madhuben Patel Cardiac Centre, Shree Krishna Hospital, Anand, IND
| | - Bhadra Y Trivedi
- Pediatric Cardiology, Bhanubhai and Madhuben Patel Cardiac Centre, Shree Krishna Hospital, Anand, IND
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Kanwar SS, Downey SA, Tandon YK. An Unusual Case of Lung Consolidation: Thinking Beyond Pneumonia. Am J Med 2021; 134:477-481. [PMID: 32997979 DOI: 10.1016/j.amjmed.2020.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 08/25/2020] [Accepted: 08/25/2020] [Indexed: 11/19/2022]
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21
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Ganarin A, Sgrò A, Garcia Magne M, Volpe A, Tognon C, Gamba P. Thoracoscopy versus thoracotomy for congenital lung malformations treatment: A single center experience. Pediatr Pulmonol 2021; 56:196-202. [PMID: 33111504 DOI: 10.1002/ppul.25138] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/13/2020] [Accepted: 10/22/2020] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Our aim is to compare thoracoscopy to thoracotomy in the treatment of congenital lung malformations (CLM) in children. MATERIALS AND METHODS We report a retrospective monocentric cohort study. Patients treated at our Center for CLM (1991-2020) were divided in two groups: patients treated with video-assisted thoracoscopic surgery (VATS) and open thoracotomy (OT). Characteristics of the two groups were compared through statistical analysis (GraphPad Prism7). A p value less than .05 was considered statistically significant. RESULTS One hundred six patients were included: 58 in VATS group, 48 in OT group. Prenatal diagnosis was possible in 73.6%. The most frequent surgical procedures were lobectomy (43.4%) and sequestrectomy (22.6%). All VATS patients underwent lung exclusion, mostly by endobronchial blocker (69%). Mean operative time was 146.1 min (±52.04 SD) in VATS and 159.2 (±46.53 SD) in OT (p = .1973). Conversion to OT was necessary in 20.6% of VATS patients, but decreased in the last 5 years (6.2%). There were not any intraoperative complication. Respectively in VATS and OT group, length of stay (LOS) was 4.5 days ± 3.6 SD versus 7.7 ± 3.4 SD (p < .0001), chest tube duration 2.8 days ± 3.4 SD versus 3.7 ± 2.4 SD (p < .0001), antibiotic treatment duration 3.7 days ± 4.7 SD versus 5 ± 2.6 SD (p = .1196). Postoperative complications were described in 22.6%. The commonest histological diagnosis (40.6%) was congenital pulmonary airway malformation. CONCLUSION VATS resulted a feasible, effective and safe technique. Operative time and postoperative complications were similar in VATS and OT groups. VATS conversion rate decreased in time. VATS had a statistically significant shorter LOS and chest tube duration.
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Affiliation(s)
- Alba Ganarin
- Pediatric Surgery Unit, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy
| | - Alberto Sgrò
- Pediatric Surgery Unit, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy
| | - Miguel Garcia Magne
- Pediatric Surgery Unit, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy
| | - Andrea Volpe
- Pediatric Surgery Unit, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy
| | - Costanza Tognon
- Pediatric Anesthesiology Unit, Department of Surgery, University Hospital of Padova, Padova, Italy
| | - Piergiorgio Gamba
- Pediatric Surgery Unit, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy
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22
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Brucknerová J, Babala J, Ujházy E, Mach M, Juránek I, Brucknerová I. Rare causes of respiratory insufficiency in newborns. Physiol Res 2020; 69:S637-S647. [PMID: 33646006 PMCID: PMC8603702 DOI: 10.33549/physiolres.934613] [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: 10/06/2020] [Accepted: 11/05/2020] [Indexed: 11/25/2022] Open
Abstract
Congenital lung masses (CLM) the rare group of causes of acute respiratory insufficiency (RI) in newborns include congenital airway pulmonary malformation (CAPM), congenital overinflation, bronchopulmonary sequestration, and bronchial atresia. The presenting group consists of 13 newborns who were admitted to the Neonatal Department of Intensive Medicine (NDIM) during January 1st 2015-December 31st 2019 (8 males, 5 females, 2 premature/11 term newborns, spontaneous delivery: 2, caesarean section: 11) with positive prenatal diagnosis of CAPM in all cases. In 2 cases prenatal intervention was performed (drainage of the amniotic fluid, attempt of thoracentesis). Signs of acute RI immediately after delivery were seen in 5 newborns. Postnatal echocardiographic investigation confirmed the presence of increased pulmonary pressure in 8 patients, no patient had congenital heart abnormality. A thorax x-ray was positive also in asymptomatic patients. Computed tomography in patients brought detailed information about the position, size and character of CAPM. Six patients underwent surgery. In 15.4 % right lungs were affected by cystic malformation and in 23 % left lungs were affected. A final diagnosis of CAPM was confirmed in 5 patients using histopathologic examination. Multidisciplinary cooperation during prenatal as well as postnatal period is necessary.
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Affiliation(s)
- J Brucknerová
- Neonatal Department of Intensive Medicine Comenius University in Bratislava, National Institute of Children's Diseases, Bratislava, Slovak Republic.
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23
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Gabelloni M, Faggioni L, Accogli S, Aringhieri G, Neri E. Pulmonary sequestration: What the radiologist should know. Clin Imaging 2020; 73:61-72. [PMID: 33310586 DOI: 10.1016/j.clinimag.2020.11.040] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 11/13/2020] [Accepted: 11/24/2020] [Indexed: 12/11/2022]
Abstract
Pulmonary sequestration consists of a nonfunctioning mass of lung tissue, either sharing the pleural envelope of the normal lung (intralobar) or with its own pleura (extralobar), lacking normal communication with the tracheobronchial tree and receiving its arterial supply by one or more systemic vessels. It is the second most common congenital lung anomaly according to pediatric case series, but its real prevalence is likely to be underestimated, and imaging plays a key role in the diagnosis and treatment management of the condition and its potential complications. We will give a brief overview of the pathophysiology, clinical presentation and imaging findings of intra- and extralobar pulmonary sequestration, with particular reference to multidetector computed tomography as part of a powerful and streamlined diagnostic approach.
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Affiliation(s)
- Michela Gabelloni
- Diagnostic and Interventional Radiology, Department of Translational Research, University of Pisa, Via Roma, 67, 56126 Pisa, Italy
| | - Lorenzo Faggioni
- Diagnostic and Interventional Radiology, Department of Translational Research, University of Pisa, Via Roma, 67, 56126 Pisa, Italy.
| | - Sandra Accogli
- Diagnostic and Interventional Radiology, Department of Translational Research, University of Pisa, Via Roma, 67, 56126 Pisa, Italy
| | - Giacomo Aringhieri
- Diagnostic and Interventional Radiology, Department of Translational Research, University of Pisa, Via Roma, 67, 56126 Pisa, Italy
| | - Emanuele Neri
- Diagnostic and Interventional Radiology, Department of Translational Research, University of Pisa, Via Roma, 67, 56126 Pisa, Italy
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24
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Hermelijn SM, Dragt OV, Bosch JJ, Hijkoop A, Riera L, Ciet P, Wijnen RMH, Schnater JM, Tiddens HAWM. Congenital lung abnormality quantification by computed tomography: The CLAQ method. Pediatr Pulmonol 2020; 55:3152-3161. [PMID: 32808750 PMCID: PMC7590128 DOI: 10.1002/ppul.25032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/29/2020] [Accepted: 08/08/2020] [Indexed: 12/15/2022]
Abstract
INTRODUCTION To date, no consensus has been reached on the optimal management of congenital lung abnormalities, and factors predicting postnatal outcome have not been identified. We developed an objective quantitative computed tomography (CT) scoring method, and assessed its value for clinical decision-making. METHODS Volumetric CT-scans of all patients born with a congenital lung abnormality between January 1999 and 2018 were assessed. Lung disease was quantified using the newly-developed congenital lung abnormality quantification (CLAQ) scoring method. In 20 equidistant axial slices, cells of a square grid were scored according to the abnormality within. The scored CT parameters were used to predict development of symptoms, and SD scores for spirometry and exercise tolerance (Bruce treadmill test) at 8 years of age. RESULTS CT-scans of 124 patients with a median age of 5 months were scored. Clinical diagnoses included congenital pulmonary airway malformation (49%), bronchopulmonary sequestration (27%), congenital lobar overinflation (22%), and bronchogenic cyst (1%). Forty-four patients (35%) developed symptoms requiring surgery of whom 28 (22%) patients became symptomatic before a CT-scan was scheduled. Lesional hyperdensity was found as an important predictor of symptom development and decreased exercise tolerance. Using receiver operating characteristic analysis, an optimal cut-off value for developing symptoms was found at 18% total disease. CONCLUSION CT-quantification of congenital lung abnormalities using the CLAQ method is an objective and reproducible system to describe congenital lung abnormalities on chest CT. The risk for developing symptoms may increase when more than a single lung lobe is affected.
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Affiliation(s)
- Sergei M Hermelijn
- Department of Paediatric Surgery, Erasmus University Medical Centre, Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Olivier V Dragt
- Department of Paediatric Pulmonology, Erasmus University Medical Centre, Sophia Children's Hospital, Rotterdam, the Netherlands.,Department of Radiology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Jochem J Bosch
- Department of Paediatric Pulmonology, Erasmus University Medical Centre, Sophia Children's Hospital, Rotterdam, the Netherlands.,Department of Radiology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Annelieke Hijkoop
- Department of Paediatric Surgery, Erasmus University Medical Centre, Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Luis Riera
- Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Pierluigi Ciet
- Department of Paediatric Pulmonology, Erasmus University Medical Centre, Sophia Children's Hospital, Rotterdam, the Netherlands.,Department of Radiology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - René M H Wijnen
- Department of Paediatric Surgery, Erasmus University Medical Centre, Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Johannes Marco Schnater
- Department of Paediatric Surgery, Erasmus University Medical Centre, Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Harm A W M Tiddens
- Department of Paediatric Pulmonology, Erasmus University Medical Centre, Sophia Children's Hospital, Rotterdam, the Netherlands.,Department of Radiology, Erasmus University Medical Centre, Rotterdam, the Netherlands
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25
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Saleh ME, Beshir H, Awad G, ElDerie A, Sanad M. Surgical outcomes for pediatric congenital lung malformation: 13 years' experience. Indian J Thorac Cardiovasc Surg 2020; 36:608-618. [PMID: 32837048 PMCID: PMC7418582 DOI: 10.1007/s12055-020-00977-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 05/21/2020] [Accepted: 05/27/2020] [Indexed: 12/15/2022] Open
Abstract
Background Congenital lung malformations (CLM) are a gamut of lesions that originate throughout the embryonic period and manifest in the neonatal or sporadically in the prenatal period, characteristically might stay well for some time, to be found inadvertently or to present with complications. In the 13 years from Jan. 2003 to Dec. 2015, this prospective cohort study included consecutive pediatric patients under 12 years old, who presented either emergently or electively with any variety of CLM. The lesions encompassed in this assortment were congenital lobar emphysema (CLE), congenital pulmonary airway malformation (CPAM), bronchogenic cysts (BC), and bronchopulmonary sequestration (BPS). Results Sixty-eight pediatric patients with CLM were operated at our institution; 18 CPAMs, 22 CLEs, 19 BPSs (17 intralobar and 2 extralobar), and 9 patients with BCs. The patients’ age ranged from 1 to 54 months (mean age of 10.73 ± 9.73 months), with overall male gender predominance (61.76%). Both CLE and CPAM had a male predominance, while BC and BPS had equivocal gender distribution. CLE patients had the earliest presentation at 2.89 ± 1.5 months and congenital cystic adenomatoid malformations (CCAM) had the latest presentation at 21.78 ± 15.6 months (F = 15.27, p < 0.0001). Lobectomy was the commonest procedure performed. Fifty-nine lobectomies were performed (21 LUL, 15 RLL, 14 LLL, 8 RUL, and 1 middle lobectomy). Six cystectomies were performed for BC. Twenty-three cases (33.8%) had postoperative complications that were mainly significant or prolonged air leak (13.24%), pneumonia (5.88%), 3 cases of hemothorax (4.4%), pulmonary atelectasis in 2 patients (2.94%), 1 patient developed effusion (1.47%), and there were 2 mortalities. Conclusions CLM must be in mind in the differential diagnoses of any case with repeated infection, respiratory distress, or radiological abnormalities. Surgery in the form of lobectomy or lesser resection is generally safe. Electronic supplementary material The online version of this article (10.1007/s12055-020-00977-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Hatem Beshir
- Department of Cardiothoracic Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.,Department of Cardiothoracic Surgery, Egypt Ministry of Health and Population, Alexandria, Egypt
| | - Gehad Awad
- Department of Cardiothoracic Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ahmad ElDerie
- Department of Cardiothoracic Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohammed Sanad
- Department of Cardiothoracic Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.,Department of Cardiothoracic Surgery, Egypt Ministry of Health and Population, Nasser Institute for Research and Treatment, Cairo, Egypt
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Trabalza Marinucci B, Maurizi G, Vanni C, Cardillo G, Poggi C, Pardi V, Inserra A, Rendina EA. Surgical treatment of pulmonary sequestration in adults and children: long-term results. Interact Cardiovasc Thorac Surg 2020; 31:71-77. [PMID: 32300793 DOI: 10.1093/icvts/ivaa054] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 01/11/2020] [Accepted: 01/30/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Few experiences comparing paediatric and adult patients treated for pulmonary sequestration (PS) have been reported. Surgical treatment is considered the best choice, but the time of surgery is still controversial. We present our experience in this setting, comparing characteristics, histological results and outcome of paediatric and adult patients undergoing PS resection. METHODS Between 1998 and 2017, a total of 74 patients underwent lobectomy or sublobar resection for PS. Sixty patients were children (group A: ≤16 years old) and 14 were adults (group B: >16 years old). Preoperative diagnosis was radiological. PS was intralobar (42 cases) and extralobar (32 cases). The operation was a muscle-sparing lateral thoracotomy or video-assisted thoracoscopic surgery. Preoperative characteristics, histological results and short-/long-term results of the 2 groups were retrospectively analysed and compared. RESULTS Thirty-seven percent of the patients in group A presented with respiratory symptoms and 79% in group B (P = 0.44). Most symptomatic patients were treated with a lobectomy. In group A, 2 patients (3%) had a malignant transformation of the lesion. Patients with a prenatal diagnosis treated after the age of 1 year became more symptomatic than those operated on before the age of 1 year (57% vs 23%; P = 0.08). No differences were found in postoperative complications. Long-term stable remission of respiratory symptoms was obtained in 91% of patients in group A and 100% in group B. Adulthood (P = 0.03) and the association with congenital cystic adenomatoid malformation (P = 0.03) were negative prognostic factors for the development of respiratory symptoms. CONCLUSIONS Surgical treatment of PS is safe and feasible. Despite the small number of patients included, study results indicated that an early operation during childhood may prevent the subsequent development of respiratory symptoms. Surgical treatment is also recommended to prevent the rare transformation into malignancy.
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Affiliation(s)
| | - Giulio Maurizi
- Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Camilla Vanni
- Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Giuseppe Cardillo
- Department of Thoracic Surgery, San Camillo Forlanini Hospital, Rome, Italy
| | - Camilla Poggi
- Department of Thoracic Surgery, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Valerio Pardi
- Department of General and Thoracic Surgery, Bambino Gesù Children's Research Hospital IRCCS, Rome, Italy
| | - Alessandro Inserra
- Department of General and Thoracic Surgery, Bambino Gesù Children's Research Hospital IRCCS, Rome, Italy
| | - Erino A Rendina
- Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University, Rome, Italy
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Lei Q, Zeng W, Ju R. Congenital lobar emphysema in bilateral lung lobes: a case report. Transl Pediatr 2020; 9:266-271. [PMID: 32775245 PMCID: PMC7347767 DOI: 10.21037/tp-19-147] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 05/11/2020] [Indexed: 11/06/2022] Open
Abstract
Congenital lobar emphysema (CLE) is a rare congenital anomaly of lung. It presents different respiratory symptoms due to affected lobar emphysema, compression atelectasis and mediastinal shift. It can affect one or more lobes. There is usually no typical clinical manifestation in clinic. Typical X-ray can help to diagnose. We report a case of neonatal CLE, which first appeared in the right middle lobar. After right middle lobe (RML) lobectomy, respiratory distress appeared again. Emphysema was found again in the left lower lung. The multiple lobes emphysema appear at different times, and this case occurred after lobectomy.
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Affiliation(s)
- Qiaoling Lei
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, Chengdu, China
| | - Wen Zeng
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, Chengdu, China
| | - Rong Ju
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, Chengdu, China
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28
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Abdel-Bary M, Abdel-Naser M, Okasha A, Zaki M, Abdel-Baseer K. Clinical and surgical aspects of congenital lobar over-inflation: a single center retrospective study. J Cardiothorac Surg 2020; 15:102. [PMID: 32429981 PMCID: PMC7236189 DOI: 10.1186/s13019-020-01145-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/04/2020] [Indexed: 12/04/2022] Open
Abstract
Background Congenital lobar overinflation (CLOI) is one of the most important causes of infantile respiratory distress (RD). We aim to evaluate our experience in CLOI management emphasizing on clinical features, diagnostic modalities, surgery and outcomes. Methods This is a retrospective study for all CLOI cases undergoing surgical management at Qena University Hospital. Demographic data, clinical data, radiographic findings, surgery and postoperative follow-up were reviewed. Results A total of 37 neonates and infants with CLOI were presented to our center between January 2015 and January 2019; their mean age was 111.43 ± 65.19 days and 22 were males. All cases presented with RD; and cyanosis in 19 cases. 15 cases presented with recurrent pneumonia and fever. Diminished breath sounds on the affected side and wheezes were the main clinical findings in 30 and 22 cases respectively. On CXR, emphysema was detected in all cases. A confirmatory CT chest was done for all cases. Left upper lobe was affected in 23 cases, right middle lobe in 7 and right upper lobe in 7 cases. Lobectomy was done in thirty-one cases; their mean age at surgery was 147.58 ± 81.49 days and 19 were males. Postoperative complications were noted in 5 cases and postoperative ventilation was required for 2 of them. No morbidity or mortality was reported. The follow-up duration ranged from 3 months to 1 year and all patients were doing well except one case that lost follow up after 3 months. Conclusion CLOI is a rare bronchopulmonary malformation that requires a high index of clinical suspicion, especially in persistent and recurrent infantile RD. CT chest is the most useful diagnostic modality. Early management of CLOI improves outcome and avoid life-threatening complications. Surgical management is the treatment of choice in our center without recorded mortality.
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Affiliation(s)
- Mohamed Abdel-Bary
- Department of Cardiothoracic Surgery, Qena Faculty of Medicine, South Valley University, Safaga Road, Qena, 83523, Egypt.
| | - Mohamed Abdel-Naser
- Department of Anaesthesia and ICU, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ahmed Okasha
- Department of Radiology, Qena Faculty of Medicine, South Valley University, Qena, Egypt
| | - Mohammed Zaki
- Department of Radiology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Khaled Abdel-Baseer
- Department of Pediatrics, Qena Faculty of Medicine, South Valley University, Qena, Egypt
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29
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Gur M, Kremer R, Bentur L. Thoracoscopic surgery for congenital lung lesions-is this the future? J Thorac Dis 2020; 12:1280-1282. [PMID: 32395263 PMCID: PMC7212152 DOI: 10.21037/jtd.2020.03.36] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Michal Gur
- Pediatric Pulmonary Institute and CF Center, Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel.,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Ran Kremer
- Department of Thoracic Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Lea Bentur
- Pediatric Pulmonary Institute and CF Center, Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel.,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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30
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Applications of Pediatric Body CT Angiography: What Radiologists Need to Know. AJR Am J Roentgenol 2020; 214:1019-1030. [DOI: 10.2214/ajr.19.22274] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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31
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Lee NH, Ahn HY, Cho JS. Superior Mediastinal Mass Revealed as Bronchopulmonary Sequestration Supplied by a Branch of the Left Pulmonary Artery. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2020; 53:89-91. [PMID: 32309210 PMCID: PMC7155181 DOI: 10.5090/kjtcs.2020.53.2.89] [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: 08/09/2019] [Revised: 09/27/2019] [Accepted: 09/28/2019] [Indexed: 11/16/2022]
Abstract
Bronchopulmonary sequestration (BPS) is a rare congenital abnormality of the lower airway, generally characterized by blood supply received from the systemic circulation. We present a rare case of a 19-year-old man with incidentally detected BPS supplied by a branch of a pulmonary artery, rather than a systemic artery. Computed tomography showed a sequestered segment supplied by a branch of the left pulmonary artery and containing an ectopic bronchus. As chest computed tomography revealed necrosis in the sequestered tissue, infection was presumed, and the tissue was surgically removed. This may represent a very unusual occurrence, as such cases have yet to be reported in the literature.
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Affiliation(s)
- Na Hyeon Lee
- Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Busan, Korea
| | - Hyo Yeong Ahn
- Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Busan, Korea
| | - Jeong Su Cho
- Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Busan, Korea
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32
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Congenital lobar emphysema in an infant with concurrent bilateral pneumothorax. Rechtsmedizin (Berl) 2020. [DOI: 10.1007/s00194-020-00386-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Pollak M, Gur M, Bronshtein M, Solt I, Masarweh K, Bentur L. Incidence of congenital thoracic malformations detected by prenatal ultrasound. Pediatr Int 2020; 62:89-93. [PMID: 31705721 DOI: 10.1111/ped.14048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 09/09/2019] [Accepted: 11/01/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND The increased and earlier use of prenatal ultrasound has facilitated the detection of congenital thoracic malformations (CTMs). Our Pediatric Pulmonology Institute follows an increasing number of patients with CTMs. Thus, we aimed to evaluate and describe prenatal sonographic findings of CTM, and to estimate changes in detection rates of CTMs over a period of 16 years. METHODS A retrospective, cross-section analysis of prenatal ultrasound (US) screening tests carried out in a large community-based clinic, comparing two periods: 2001-2007 and 2007-2017. RESULTS A total of 34 716 prenatal US were performed at a median gestational age of 15.4 weeks (range, 11.6-23.9) and 15.7 weeks (range, 12-33.6) in 2001-2007 and 2007-2017, respectively. In 2001-2007, 12 016 prenatal US tests detected 19 CTMs, compared to 30 CTMs in 22 700 tests in 2007-2017. Detection rates did not change (1.58/1,000 in 2001-2007 versus 1.32/1,000 in 2007-2017, P = 0.64). The most common abnormality was congenital pleural effusion (CPE) (17 cases, 34.7%), followed by congenital pulmonary airway malformation) and congenital diaphragmatic hernia; 13 cases each, 26.5%. Twenty CTMs, mainly congenital diaphragmatic hernia and CPE, were associated with other fetal lesions. CONCLUSIONS Congenital diaphragmatic hernia and CPE tend to appear with multiple lesions and warrant further attention. The incidence rates stayed stable when comparing the last decade to previous years. Thus, the increased referral of CTM can be attributed to an increase in the number of prenatal screening studies performed, rather than a true higher incidence.
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Affiliation(s)
- Mordechai Pollak
- Pediatric Pulmonary Institute, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel.,Department of Pediatrics, Bnei Zion Medical Center, Haifa, Israel
| | - Michal Gur
- Pediatric Pulmonary Institute, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel.,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Moshe Bronshtein
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel
| | - Ido Solt
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel
| | - Kamal Masarweh
- Pediatric Pulmonary Institute, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Lea Bentur
- Pediatric Pulmonary Institute, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel.,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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34
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Konca C, Tekin M, Elmas OC. Concurrence of Two Rare Conditions: Simultaneous Bilateral Spontaneous Pneumothorax and Congenital Pulmonary Airway Malformation. J Pediatr Intensive Care 2019; 8:178-180. [PMID: 31404456 DOI: 10.1055/s-0039-1677814] [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: 10/18/2018] [Accepted: 01/01/2019] [Indexed: 10/27/2022] Open
Abstract
Simultaneous bilateral spontaneous pneumothorax (SBSP) is a very rare type of pneumothorax. Most reported cases are associated with underlying lung diseases. In a small number of pediatric studies, SBSP was found to be associated with human bocavirus bronchiolitis, Langerhans cell histiocytosis, and Mycoplasma pneumoniae infection. The present work examines an interesting case of type 2 congenital pulmonary airway malformation presenting with SBSP and bilateral multiple parenchymal cysts.
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Affiliation(s)
- Capan Konca
- Division of Pediatric Intensive Care Unit, School of Medicine, Adiyaman University, Adiyaman, Turkey.,Department of Pediatrics, School of Medicine, Adiyaman University, Turkey
| | - Mehmet Tekin
- Division of Pediatric Intensive Care Unit, School of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Oksan Cebeci Elmas
- Division of Pediatric Intensive Care Unit, School of Medicine, Adiyaman University, Adiyaman, Turkey
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35
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Demir OF, Hangul M, Kose M. Congenital lobar emphysema: diagnosis and treatment options. Int J Chron Obstruct Pulmon Dis 2019; 14:921-928. [PMID: 31118601 PMCID: PMC6507121 DOI: 10.2147/copd.s170581] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 04/16/2019] [Indexed: 12/19/2022] Open
Abstract
Although congenital lobar emphysema is a rare lung disease, it can cause severe respiratory distress in the newborn. Lobectomy can be difficult because of the hyperinflated lobe and limited space to carry out surgery. During the past two decades, conservative treatment options have increased for patients with mild and moderate disease.
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Affiliation(s)
- Omer Faruk Demir
- Department of Thoracic Surgery, Erciyes University, Kayseri, Turkey
| | - Melih Hangul
- Department of Pediatrics, Division of Pediatric Pulmonology, Erciyes University, Kayseri, Turkey
| | - Mehmet Kose
- Department of Pediatrics, Division of Pediatric Pulmonology, Erciyes University, Kayseri, Turkey
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36
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Khatib N, Beloosesky R, Ginsberg Y, Lea B, Michal G, Weiner Z, Bronshtein M. Early sonographic manifestation of fetal congenital lobar emphysema. JOURNAL OF CLINICAL ULTRASOUND : JCU 2019; 47:225-227. [PMID: 30575052 DOI: 10.1002/jcu.22674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 11/01/2018] [Accepted: 11/06/2018] [Indexed: 06/09/2023]
Abstract
Advanced fetal sonographic equipment has contributed to the increase in prenatal diagnosis of congenital thoracic malformations. Among these anomalies is congenital lobar emphysema (CLE), a rare congenital anomaly characterized by over distention and overexpansion of the involved fetal pulmonary lobe. Several studies addressed the prenatal diagnosis of CLE in mid second or early third trimester. The early prenatal diagnosis and the outcome of a case of CLE are reported in this study.
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Affiliation(s)
- Nizar Khatib
- Department of Ob/Gyn, RAMBAM Health Care Campus, Haifa, Israel
| | - Ron Beloosesky
- Department of Ob/Gyn, RAMBAM Health Care Campus, Haifa, Israel
- Department OB/GYN and University of Haifa, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Yuval Ginsberg
- Department of Ob/Gyn, RAMBAM Health Care Campus, Haifa, Israel
| | - Bentur Lea
- Department OB/GYN and University of Haifa, Pediatric Pulmonary Institute, Ruth Rappaport Children's Hospital, RAMBAM Health Care Campus, Haifa, Israel
| | - Gur Michal
- Department OB/GYN and University of Haifa, Pediatric Pulmonary Institute, Ruth Rappaport Children's Hospital, RAMBAM Health Care Campus, Haifa, Israel
| | - Zeev Weiner
- Department of Ob/Gyn, RAMBAM Health Care Campus, Haifa, Israel
- Department OB/GYN and University of Haifa, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Moshe Bronshtein
- Department of Ob/Gyn, RAMBAM Health Care Campus, Haifa, Israel
- Department OB/GYN and University of Haifa, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
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37
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Annunziata F, Bush A, Borgia F, Raimondi F, Montella S, Poeta M, Borrelli M, Santamaria F. Congenital Lung Malformations: Unresolved Issues and Unanswered Questions. Front Pediatr 2019; 7:239. [PMID: 31249823 PMCID: PMC6584787 DOI: 10.3389/fped.2019.00239] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 05/28/2019] [Indexed: 12/30/2022] Open
Abstract
Advances in prenatal and postnatal diagnosis, perioperative management, and postoperative care have dramatically increased the number of scientific reports on congenital thoracic malformations (CTM). Nearly all CTM are detected prior to birth, generally by antenatal ultrasound. After delivery, most infants do well and remain asymptomatic for a long time. However, complications may occur beyond infancy, including in adolescence and adulthood. Prenatal diagnosis is sometimes missed and detection may occur later, either by chance or because of unexplained recurrent or persistent respiratory symptoms or signs, with difficult implications for family counseling and substantial delay in surgical planning. Although landmark studies have been published, postnatal management of asymptomatic children is still controversial and needs a resolution. Our aim is to provide a focused overview on a number of unresolved issues arising from the lack of an evidence-based consensus on the management of patients with CTM. We summarized findings from current literature, with a particular emphasis on the vigorous controversies on the type and timing of diagnostic procedures, treatments and the still obscure relationship between CTM and malignancies, a matter of great concern for both families and physicians. We also present an algorithm for the assessment and follow-up of CTM detected either in the antenatal or postnatal period. A standardized approach across Europe, based on a multidisciplinary team, is urgently needed for achieving an evidence-based management protocol for CTM.
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Affiliation(s)
- Federica Annunziata
- Division of Paediatrics, Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Andrew Bush
- Department of Paediatrics and Paediatric Respiratory Medicine, Imperial College and Royal Brompton Hospital, London, United Kingdom
| | - Francesco Borgia
- Divisions of Cardiology and Cardiothoracic Surgery, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - Francesco Raimondi
- Division of Paediatrics, Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Silvia Montella
- Division of Paediatrics, Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Marco Poeta
- Division of Paediatrics, Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Melissa Borrelli
- Division of Paediatrics, Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Francesca Santamaria
- Division of Paediatrics, Department of Translational Medical Sciences, Federico II University, Naples, Italy
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38
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Shah MA, Shah I. Not all hemoptysis is tuberculosis - It could be intralobar bronchopulmonary sequestration. Lung India 2019; 36:72-73. [PMID: 30604710 PMCID: PMC6330792 DOI: 10.4103/lungindia.lungindia_425_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Miti Aatish Shah
- Department of Pediatrics, Pediatric TB Clinic, B J Wadia Hospital for Children, Mumbai, Maharashtra, India
| | - Ira Shah
- Department of Pediatrics, Pediatric TB Clinic, B J Wadia Hospital for Children, Mumbai, Maharashtra, India
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Cosme HW, Lima LS, Barbosa LG. PREVALENCE OF CONGENITAL ANOMALIES AND THEIR ASSOCIATED FACTORS IN NEWBORNS IN THE CITY OF SÃO PAULO FROM 2010 TO 2014. REVISTA PAULISTA DE PEDIATRIA 2018; 35:33-38. [PMID: 28977314 PMCID: PMC5417807 DOI: 10.1590/1984-0462/;2017;35;1;00002] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 07/03/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To study the prevalence of congenital anomalies in newborns in the city of São Paulo from 2010 to 2014, as well as to analyze other variables associated with the anomalies. METHODS Data was collected from the Ministry of Health's Live Births Information System (SINASC) from 2010 to 2014 in São Paulo City. The variables analyzed were length and type of pregnancy, maternal age, and ethnicity and sex of the newborn. The absolute and relative frequencies of congenital anomalies were verified, and the variables associated with them were calculated with the odds ratio (OR) and a 95% confidence interval. RESULTS A total of 819,018 live births occurred in the city of São Paulo, and in 14,657 (1.6%) of them, some congenital anomaly was reported. The most frequent congenital anomalies found were those related to osteoarticular system followed by those related to the cardiovascular system. Risks associated with the presence of congenital anomalies were observed in the following factors: maternal age over 40 years (OR=1.59; 95%CI 1.47-1.71), multiple pregnancies (OR=1.28; 95%CI 1.19-3.77), and low birth weight (OR=3.35; 95%CI 3.21-3.49). The female gender was considered a protective variable (OR=0.78; 95%CI 0.75-0.81). CONCLUSIONS Congenital anomalies are responsible for morbidity and mortality in the neonatal period. Their early diagnosis is important for planning and resource allocation of specialized health services directed toward the families and infants.
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40
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Ursini WP, Ponce CC. Congenital pulmonary airway malformation. AUTOPSY AND CASE REPORTS 2018; 8:e2018022. [PMID: 29780758 PMCID: PMC5953188 DOI: 10.4322/acr.2018.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 04/16/2018] [Indexed: 02/01/2023] Open
Abstract
Congenital pulmonary airway malformation (CPAM) is a developmental malformation of the lower respiratory tract. We report the case of a male newborn diagnosed with cystic lung disease during prenatal ultrasound. A cesarean section was performed at the 32nd gestational week because of premature rupture of the membranes, and soon after the delivery the newborn developed respiratory failure and died. The aim of this study is to report an autopsy case because of its rarity, and to briefly discuss the CPAM subtypes and differential diagnosis of cystic lung diseases of childhood.
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Affiliation(s)
- Wlamir Pestana Ursini
- Hospital Guilherme Alvaro Santos, Department of Pathology . Santos, SP , Brazil.,Metropolitan University of Santos (UNIMES), Department of Pathology . Santos, SP , Brazil
| | - Cesar Cilento Ponce
- Hospital Guilherme Alvaro Santos, Department of Pathology . Santos, SP , Brazil.,Metropolitan University of Santos (UNIMES), Department of Pathology . Santos, SP , Brazil
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41
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Fabbri N, Tamburini N, Galeotti R, Quarantotto F, Maniscalco P, Rinaldi R, Salviato E, Cavallesco G. A rare case of intralobar pulmonary sequestration: combined endovascular and video-assisted thoracoscopic approach. AME Case Rep 2018; 2:19. [PMID: 30264015 DOI: 10.21037/acr.2018.04.01] [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: 03/06/2018] [Accepted: 03/21/2018] [Indexed: 11/06/2022]
Abstract
Pulmonary sequestration is a congenital malformation characterized by cystic, non-functioning embryonic lung tissue supplied by an abnormal systemic artery. It's a rare disease widely variable in clinical presentation and severity, depending mostly on the degree of lung involvement and location in the thoracic cavity. Most patients have recurrent infections and inflammatory conditions in the affected lobe. Surgical resection continues to be the gold standard of therapy and in this context anatomical resection is the procedure of choice and yields excellent long-term results. There are few studies reporting the use of combined endovascular and thoracoscopic approaches for pulmonary sequestration. We describe a case of intralobar pulmonary sequestration located in the lower lobe of the right lung, which was treated with video-assisted thoracoscopic surgery (VATS) after endovascular embolization of systemic artery arising from celiac trunk.
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Affiliation(s)
- Nicolò Fabbri
- Department of Morphology, Experimental Medicine and Surgery, Section of Chirurgia 1, Section of Pathology, Sant'Anna Hospital, University of Ferrara, Ferrara, Italy
| | - Nicola Tamburini
- Department of Morphology, Experimental Medicine and Surgery, Section of Chirurgia 1, Section of Pathology, Sant'Anna Hospital, University of Ferrara, Ferrara, Italy
| | - Roberto Galeotti
- Department of Radiology, Section of Interventional Radiology, Section of Pathology, Sant'Anna Hospital, University of Ferrara, Ferrara, Italy
| | - Francesco Quarantotto
- Department of Morphology, Experimental Medicine and Surgery, Section of Chirurgia 1, Section of Pathology, Sant'Anna Hospital, University of Ferrara, Ferrara, Italy
| | - Pio Maniscalco
- Department of Morphology, Experimental Medicine and Surgery, Section of Chirurgia 1, Section of Pathology, Sant'Anna Hospital, University of Ferrara, Ferrara, Italy
| | - Rosa Rinaldi
- Department of Experimental and Diagnostic Medicine, Section of Pathology, Sant'Anna Hospital, University of Ferrara, Ferrara, Italy
| | - Elisabetta Salviato
- Department of Radiology, Section of Interventional Radiology, Section of Pathology, Sant'Anna Hospital, University of Ferrara, Ferrara, Italy
| | - Giorgio Cavallesco
- Department of Morphology, Experimental Medicine and Surgery, Section of Chirurgia 1, Section of Pathology, Sant'Anna Hospital, University of Ferrara, Ferrara, Italy
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42
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Bentur L, Gur M, Pollak M, Masarweh K, Solt I, Bronshtein M. Early prenatal ultrasound diagnosis of congenital thoracic malformations. J Matern Fetal Neonatal Med 2018; 32:3531-3536. [PMID: 29720002 DOI: 10.1080/14767058.2018.1465920] [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] [Indexed: 10/17/2022]
Abstract
Objectives: To evaluate and describe the spectrum and rate of congenital thoracic malformations (CTMs) diagnosed by early prenatal sonography (gestational age (GA) less than 16 weeks). Methods: A retrospective, cross-sectional analysis of prenatal ultrasound screening tests in a community-based clinic. Results: In 2001-2017, 31 261 prenatal ultrasound tests detected 31 CTMs at a gestational age of 15.2 (range, 11.6-16.0) weeks. The most common malformation was congenital pleural effusion (CPE) (15 fetuses, 0.48/1000), followed by congenital diaphragmatic hernia (CDH) (10 fetuses, 0.32/1000). Pulmonary hypoplasia (PH), congenital pulmonary airway malformation and broncho-pulmonary sequestration appeared in much smaller proportions (three, two and one fetuses, respectively). Most CTMs were associated with additional fetal lesions (15 fetuses, 48%). All early CDH (10 fetuses) and PH (three fetuses) and 6/15 with CPE had termination of pregnancy or missed abortions. Conclusions: Prenatal ultrasound before 16 GA was able to detect CTMs in 0.99/1000 of screening ultrasound (US) performed. Most CTMs tended to appear with multiple lesions and were associated with unfavorable outcomes. Earlier prenatal diagnosis may enable early termination of pregnancy in fetuses with lethal malformations.
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Affiliation(s)
- Lea Bentur
- a Pediatric Pulmonary Institute, Ruth Rappaport Children's Hospital, Rambam Health Care Campus , Haifa , Israel.,b Rappaport Faculty of Medicine , Technion - Israel Institute of Technology , Haifa , Israel
| | - Michal Gur
- a Pediatric Pulmonary Institute, Ruth Rappaport Children's Hospital, Rambam Health Care Campus , Haifa , Israel
| | - Mordechai Pollak
- a Pediatric Pulmonary Institute, Ruth Rappaport Children's Hospital, Rambam Health Care Campus , Haifa , Israel.,c Department of Pediatrics , Bnai Zion Medical Center , Haifa , Israel
| | - Kamal Masarweh
- a Pediatric Pulmonary Institute, Ruth Rappaport Children's Hospital, Rambam Health Care Campus , Haifa , Israel
| | - Ido Solt
- b Rappaport Faculty of Medicine , Technion - Israel Institute of Technology , Haifa , Israel.,d Department of Obstetrics and Gynecology , Rambam Health Care Campus , Haifa , Israel
| | - Moshe Bronshtein
- b Rappaport Faculty of Medicine , Technion - Israel Institute of Technology , Haifa , Israel.,d Department of Obstetrics and Gynecology , Rambam Health Care Campus , Haifa , Israel
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Lin MF, Xie HN, Zhao XH, Peng R, Zheng J, Peng ZP. Systemic Venous Drainage Is Associated with an Unfavorable Prenatal Behavior in Fetal Bronchopulmonary Sequestration. Fetal Diagn Ther 2017; 44:291-298. [PMID: 29268259 DOI: 10.1159/000485035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 11/06/2017] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This study aimed to determine the significance of the venous drainage pattern of bronchopulmonary sequestration (BPS) in the prenatal course. METHODS The venous drainage pattern of fetuses with BPS was determined with high-definition flow and confirmed by postnatal three-dimensional computed tomography angiography scan or autopsy. The volume of BPS lesions during gestation was recorded by the three-dimensional ultrasonographic Virtual Organ Computer-Aided Analysis software. The relationship between venous drainage pattern and prenatal characteristics was determined. RESULTS Seventy-one fetuses were enrolled: 35 with systemic venous drainage (SVD) and 36 with pulmonary venous drainage (PVD). The volumes of BPS lesions significantly increased from the middle second trimester to the later second trimester in the SVD group. A marked decrease from the later second trimester to the third trimester was observed in the PVD group. The incidences of associated anomalies, hydrops, and polyhydramnios in the SVD group were 14.2, 23.3, and 33.3%, respectively, significantly higher than those in the PVD group (0, 0, and 5.6%, respectively). CONCLUSIONS Our data indicate that SVD is correlated with a higher risk of associated anomalies and an unfavorable prenatal course in fetal BPS. Identification of the venous drainage pattern is of clinical significance in predicting the prenatal behavior of fetal BPS.
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Affiliation(s)
- Mei-Fang Lin
- Department of Ultrasonic Medicine and Fetal Medical Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hong-Ning Xie
- Department of Ultrasonic Medicine and Fetal Medical Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou,
| | - Xiu-Hua Zhao
- Department of Ultrasonic Medicine and Fetal Medical Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ruan Peng
- Department of Ultrasonic Medicine and Fetal Medical Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ju Zheng
- Department of Ultrasonic Medicine and Fetal Medical Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhen-Peng Peng
- Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Lovera de Ferreira CT, Serra Azuara L, Asensio de la Cruz O, Bosque García MM. Congenital Pulmonary Malformations Diagnosed Over a Period of 10 Years. Arch Bronconeumol 2017; 54:165-167. [PMID: 29248259 DOI: 10.1016/j.arbres.2017.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 08/22/2017] [Accepted: 08/23/2017] [Indexed: 11/26/2022]
Affiliation(s)
| | - Laura Serra Azuara
- Unidad de Ginecología y Obstetricia, Hospital Universitario Parc Tauli, Barcelona, España
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Petty L, Joseph A, Sanchez J. Case report: Pulmonary sequestration in an adult. Radiol Case Rep 2017; 13:21-23. [PMID: 29487633 PMCID: PMC5826459 DOI: 10.1016/j.radcr.2017.09.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Revised: 09/25/2017] [Accepted: 09/28/2017] [Indexed: 11/25/2022] Open
Abstract
Pulmonary sequestration is a rare congenital malformation that is uncommonly diagnosed during adulthood. Pulmonary sequestrations can manifest with variable presentations. It can remain asymptomatic or present with more severe symptoms such as hemoptysis and recurrent pneumonia. Diagnosis can be confirmed with computed tomography angiogram or angiography. Treatment with embolization of the afferent artery and surgical removal of the pulmonary sequestration generally has good outcomes. We report a case of a 43-year-old man who presented with recurrent pneumonia and left-sided back pain and was eventually diagnosed with pulmonary sequestration.
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Affiliation(s)
- Lloyd Petty
- Palmetto General Hospital, 2001 W 68th Street, Hialeah, FL 33016, USA
| | - Arthur Joseph
- Palmetto General Hospital, 2001 W 68th Street, Hialeah, FL 33016, USA
| | - Jose Sanchez
- Palmetto General Hospital, 2001 W 68th Street, Hialeah, FL 33016, USA
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Molinaro F, Angotti R, Garzi A, Di Crescenzo VG, Cortese A, Messina M. Prenatal diagnosis, 3-D virtual rendering and lung sparing surgery by ligasure device in a baby with "CCAM and intralobar pulmonary sequestration". Open Med (Wars) 2017; 11:200-203. [PMID: 28352794 PMCID: PMC5329825 DOI: 10.1515/med-2016-0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 03/07/2016] [Indexed: 11/15/2022] Open
Abstract
Congenital cystic lung lesions are a rare but clinically significant group of anomalies, including congenital cystic adenomatoid malformation (CCAM), pulmonary sequestration, congenital lobar emphysema (CLE) and bronchogenic cysts. Despite the knowledge of these lesions increasing in the last years, some aspects are still debated and controversial. The diagnosis is certainly one aspect which underwent many changes in the last 15 years due to the improvement of antenatal scan and the introduction of 3-D reconstruction techniques. As it is known, a prompt diagnosis has an essential role in the management of these children. The new imaging studies as 3D Volume rendering system are the focus of this paper. We describe our preliminary experience in a case of hybrid lung lesion, which we approached by thoracoscopy after a preoperative study with 3D VR reconstruction. Our final balance is absolutely positive.
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Affiliation(s)
- Francesco Molinaro
- Division of Pediatric Surgery, Department of Medical, Surgical and Neurological Sciences, University of Siena, Italy
| | - Rossella Angotti
- Division of Pediatric Surgery, Department of Medical, Surgical and Neurological Sciences, University of Siena, Italy
| | - Alfredo Garzi
- Department of Medicine and Surgery, Pediatric Surgery, Piazza Sergardi, 16, 52044 Cortona (AR) Italy
| | | | - Antonio Cortese
- Department of Medicine and Surgery, Pediatric Surgery Unit, University of Salerno, Italy
| | - Mario Messina
- Division of Pediatric Surgery, Department of Medical, Surgical and Neurological Sciences, University of Siena, Italy
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Angeborene Lungenfehlbildungen. Monatsschr Kinderheilkd 2016. [DOI: 10.1007/s00112-016-0154-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Left Upper Lobectomy for Congenital Lobar Emphysema in a Low Weight Infant. Case Rep Surg 2016; 2016:4182741. [PMID: 27597924 PMCID: PMC5002461 DOI: 10.1155/2016/4182741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 06/26/2016] [Accepted: 07/21/2016] [Indexed: 11/22/2022] Open
Abstract
Congenital lobar emphysema (CLE) is a rare lung congenital malformation. Differential diagnosis of the disease remains challenging in an infant with acute respiratory distress. We report a case of a 3-week-old female infant with a weight of 2.1 kg who presented respiratory distress related to CLE. Left upper lobectomy was performed and she had an uneventful recovery.
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A case of diffuse persistent pulmonary emphysema: When is difficult the diagnosis? JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2016. [DOI: 10.1016/j.epsc.2016.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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PATOLOGÍA PULMONAR CONGÉNITA: EVALUACIÓN Y MANEJO PERINATAL. REVISTA MÉDICA CLÍNICA LAS CONDES 2016. [DOI: 10.1016/j.rmclc.2016.07.008] [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] Open
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