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Takahashi H, Kunishige M, Shinohara T. Low-attenuation clusters with reduced fractal dimension due to bronchial atresia. Am J Med Sci 2024; 368:e32-e33. [PMID: 38788927 DOI: 10.1016/j.amjms.2024.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 05/17/2024] [Indexed: 05/26/2024]
Affiliation(s)
- Hiroki Takahashi
- Division of Internal Medicine, Japan Agricultural Cooperatives Kochi Hospital, Kochi, Japan
| | - Michihiro Kunishige
- Division of Internal Medicine, Japan Agricultural Cooperatives Kochi Hospital, Kochi, Japan; Department of Community Medicine for Respirology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Tsutomu Shinohara
- Division of Internal Medicine, Japan Agricultural Cooperatives Kochi Hospital, Kochi, Japan; Department of Community Medicine for Respirology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan.
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2
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Lin H, Tian S, Niu C, Shen X, Wang M, Wan C, Shi B, Chen H, He M, Bai C, Huang H. A case of congenital bronchial atresia with tracheobronchial stenosis caused by emphysema: Successful management with thoracoscopic surgery. Heliyon 2024; 10:e32753. [PMID: 38912456 PMCID: PMC11193005 DOI: 10.1016/j.heliyon.2024.e32753] [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: 02/27/2024] [Revised: 05/04/2024] [Accepted: 06/07/2024] [Indexed: 06/25/2024] Open
Abstract
Introduction Congenital bronchial atresia (CBA), as a rare developmental abnormality of the lung, is usually asymptomatic and is accidently discovered in most cases. Currently, no standardized guidelines for the treatment or management of CBA have been established. Case presentation A 22-year-old male soldier was referred to Shanghai Changhai Hospital, The First Affiliated Hospital of Naval Medical University due to chest tightness and shortness of breath after repeated strenuous activities. Contrast-enhanced computed tomography (CT) revealed an 18mm × 11mm solitary, well-circumscribed, and solid nodule with no enhancement in the right upper lobe (RUL), and emphysematous changes distributed throughout the RUL. A flexible bronchoscopic examination showed extrinsic compression stenosis in the bronchial opening of the right middle lobe (RML). After three-dimensional (3D) reconstruction CT and a multidisciplinary consultation, a diagnosis of CBA in the anterior segment (B3) of RUL was established. Subsequently, thoracoscopic right upper lobectomy was performed and resulted in an improved respiratory capacity 6 months after surgery. To date, the patient has good quality of life without any complication. Conclusion This study underscores the role of bronchoscopy, 3D reconstruction CT, and a multidisciplinary consultation in the diagnosis of CBA, and highlights that a thoracoscopic intervention should be considered in such case.
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Affiliation(s)
- Huan Lin
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Sen Tian
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, China
- Department of Respiratory and Critical Care Medicine, No. 906 Hospital of the Chinese People's Liberation Army Joint Logistic Support Force, Ningbo, China
| | - Chunlai Niu
- Department of Rehabilitation Medicine, The Second Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Xiaping Shen
- Department of Radiology, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Mingming Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, China
- Department of Respiratory and Critical Care Medicine, The Second People's Hospital of Fuyang City, Fuyang, Anhui, China
| | - Changhong Wan
- Department of Chest, Lung and Breast Surgery, Clifford Hospital, Guangzhou, Guangdong, China
| | - Bowen Shi
- Department of Thoracic Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Hezhong Chen
- Department of Thoracic Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Miaoxia He
- Department of Pathology, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Chong Bai
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Haidong Huang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, China
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3
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Brixey AG, McCallum R. Imaging of Large Airway Disorders. Clin Chest Med 2024; 45:489-503. [PMID: 38816102 DOI: 10.1016/j.ccm.2024.02.015] [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: 06/01/2024]
Abstract
Large airway disorders encompass a large variety of diseases and pathology, with broad categories including anatomic variants, congenital abnormalities, acquired abnormalities, inflammatory/infiltrative causes, infection, and tumors. The most common diseases in each category are discussed with a focus on the salient imaging findings. Pitfalls to beware of are discussed through the article, and concludes with a general method to approaching large airways pathology that should provide the reader with a basic framework and understanding of this complex topic.
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Affiliation(s)
- Anupama Gupta Brixey
- Department of Diagnostic Radiology, Section of Cardiothoracic Imaging, Portland VA Healthcare System and Oregon Health & Science University, 3710 Southwest US Veterans Hospital Road, Portland, OR 97239, USA.
| | - Raluca McCallum
- Department of Diagnostic Radiology, Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA
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4
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Ong LT, Fan SWD. Pulmonary Complications of Cytomegalovirus Infection in Neonates and Infants: A Systematic Review of Case Reports and Pooled Analysis. Pediatr Infect Dis J 2024; 43:565-573. [PMID: 38380928 DOI: 10.1097/inf.0000000000004297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
BACKGROUND Cytomegalovirus (CMV) causes intrauterine infections in 0.67% of neonates, with 12.7% displaying symptoms at birth. CMV can lead to severe multiorgan involvement, and mortality in symptomatic cases is around 30%. Pulmonary complications are rare in infants with CMV. This review assesses pulmonary complications and outcomes in infants with CMV infection. METHODS A systematic literature search was conducted using PubMed, SCOPUS and Ovid SP to retrieve case reports on pulmonary complications in infants with congenital or perinatal CMV infection. Descriptive analysis and pooled analysis were conducted for the case reports. RESULTS A total of 28 articles with 38 patients were included in this systematic review. The reported pulmonary complications in the case reports were CMV pneumonitis (34.2%), persistent pulmonary hypertension of the newborn (18.4%), emphysema and chronic lung disease (15.8%), diaphragmatic dysfunction (13.2%), lung cysts and calcifications (10.5%), Pneumocystis jirovecii infection (7.9%), pulmonary hypoplasia (5.3%) and bronchial atresia (2.6%). Seven (18.4%) of 38 patients passed away because of the pulmonary complications of CMV infection. Congenital transmission ( P = 0.0108), maternal CMV ( P = 0.0396) and presence of neonatal comorbidities ( P = 0.0398) were independent risk factors for mortality. CONCLUSIONS This systematic review demonstrated infrequent occurrence of severe pulmonary involvement in CMV infection but should be considered in infants with persistent or severe respiratory symptoms.
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Affiliation(s)
- Leong Tung Ong
- From the Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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5
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Kumar K, Sharma N, Marwah V, Vasan AS. Congenital bronchial atresia presenting with chronic cough in a young male. Lung India 2023; 40:475-477. [PMID: 37787367 PMCID: PMC10553780 DOI: 10.4103/lungindia.lungindia_50_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 05/14/2023] [Accepted: 06/04/2023] [Indexed: 10/04/2023] Open
Affiliation(s)
- Kunal Kumar
- Department of Pulmonary and Sleep Medicine, Military Hospital Namkum, Ranchi, Jharkhand, India E-mail:
| | - Neeraj Sharma
- Department of Pulmonary and Sleep Medicine, Military Hospital Namkum, Ranchi, Jharkhand, India E-mail:
| | - Vikas Marwah
- M. D. (Respiratory Medicine), Registrar, 150 General Hospital, Rajouri, Jammu and Kashmir, India
| | - Amit S. Vasan
- Department of Pulmonary and Sleep Medicine, Command Hospital, Lucknow, Uttar Pradesh, India.
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6
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Yamagishi T, Matsuyama M, Watanabe R, Sakai C, Matsumura S, Nakajima M, Kikuchi S, Sakamoto N, Sato Y, Hizawa N. A case of secondary pneumothorax due to multiple pulmonary metastases of granulosa cell tumor. Multidiscip Respir Med 2022; 17:884. [PMID: 36589027 PMCID: PMC9796701 DOI: 10.4081/mrm.2022.884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/08/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Ovarian granulosa cell tumor is a relatively rare tumor that accounts for 2-5% of malignant ovarian tumors. This tumor progresses slowly and may recur late in life. Case presentation A 70-year-old woman was admitted to our hospital with a left secondary pneumothorax due to metastatic lung tumors of granulosa cell tumor. Reports of secondary pneumothorax due to granulosa cell tumor are rare. Thoracoscopic suturing and pleurodesis using talc were effective in the treatment of this pneumothorax. Conclusions We experienced a rare case of secondary pneumothorax due to multiple pulmonary metastases of granulosa cell tumor. It should be noted that pulmonary metastasis of granulosa cell tumor can lead to secondary pneumothorax.
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Affiliation(s)
| | - Masashi Matsuyama
- Department of Respiratory Medicine,Department of Respiratory Medicine, University of Tsukuba 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575, Japan. +81.29.853-3144.
| | | | | | | | | | | | - Noriaki Sakamoto
- Department of Diagnostic Pathology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
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7
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Lopyan NM, Perrone EE, VanHulle R, Bloom DA, Mychaliska GB, Speck KE. A single institution's experience with the management of peripheral bronchial atresia. Pediatr Surg Int 2022; 38:853-860. [PMID: 35229175 DOI: 10.1007/s00383-022-05089-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Peripheral bronchial atresia is a pulmonary abnormality diagnosed on postnatal computed tomography after prenatal imaging reveals a congenital lung lesion. Debate regarding management of this abnormality prompted us to review our institution's practice patterns and outcomes. METHODS All patients diagnosed with bronchial atresia were assessed from 6/2014 to 7/2020. Pediatric radiologists were surveyed to delineate computed tomography criteria used to diagnose peripheral bronchial atresia. Criteria were applied in an independent blinded review of postnatal imaging. Data for patients determined to have peripheral bronchial atresia and at least an initial pediatric surgical evaluation were analyzed. RESULTS Twenty-eight patients with bronchial atresia received at least an initial pediatric surgical evaluation. Expectant management was planned for 22/28 (79%) patients. Two patients transitioned from an expectant management strategy to an operative strategy for recurrent respiratory infections; final pathology revealed bronchial atresia in both. Six patients were initially managed operatively; final pathology revealed bronchial atresia (n = 3) or congenital lobar overinflation (n = 3). CONCLUSIONS Peripheral bronchial atresia can be safely managed expectantly. A change in symptoms is suspicious for alternate lung pathology, warranting further workup and consideration for resection. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Natalie M Lopyan
- Division of Pediatric Surgery, Department of Surgery, C.S. Mott Children's Hospital, University of Michigan, 1540 E. Hospital Dr., Ann Arbor, MI, USA.
| | - Erin E Perrone
- Division of Pediatric Surgery, Department of Surgery, C.S. Mott Children's Hospital, University of Michigan, 1540 E. Hospital Dr., Ann Arbor, MI, USA
- Fetal Diagnosis and Treatment Center, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA
| | - Rachel VanHulle
- Division of Pediatric Radiology, Department of Radiology, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI, USA
| | - David A Bloom
- Division of Pediatric Radiology, Department of Radiology, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI, USA
| | - George B Mychaliska
- Division of Pediatric Surgery, Department of Surgery, C.S. Mott Children's Hospital, University of Michigan, 1540 E. Hospital Dr., Ann Arbor, MI, USA
- Fetal Diagnosis and Treatment Center, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA
| | - K Elizabeth Speck
- Division of Pediatric Surgery, Department of Surgery, C.S. Mott Children's Hospital, University of Michigan, 1540 E. Hospital Dr., Ann Arbor, MI, USA
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8
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Kakarla B. Bronchocele, a common but underrecognized condition: a systematic review. Monaldi Arch Chest Dis 2022; 93. [PMID: 35477240 DOI: 10.4081/monaldi.2022.2133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 04/13/2022] [Indexed: 01/19/2023] Open
Abstract
Bronchocele is an abnormal accumulation of mucus often with associated bronchial dilatation. It can be due to either increased production or impaired drainage of mucus in the airways. Diseases like chronic bronchitis, bronchial asthma, bronchiectasis are characterized by high mucus production and other atypical conditions are bronchorrhea and plastic bronchitis with different physical characteristics and compositions of mucus. Improper drainage can lead to bronchocele formation due to underlying benign, malignant tumours or bronchial stenosis. Allergic bronchopulmonary aspergillosis (ABPA) has a peculiar appearance with high attenuated mucus (HAM) in imaging. Careful evaluation of bronchocele is needed as it can be associated with bronchial obstruction or rare causes like plastic bronchitis. Proper identification, evaluation for the underlying cause is key for not missing the underlying diagnosis and accurate treatment.
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Affiliation(s)
- Bhaskar Kakarla
- Department of Pulmonary Medicine, Nizam's Institute of Medical Sciences, Hyderabad.
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9
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Ohm B, Jungraithmayr W. Angeborene Fehlbildungen der Lunge – eine Übersicht. Zentralbl Chir 2022; 147:90-97. [DOI: 10.1055/a-1669-9574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
ZusammenfassungKongenitale pulmonale Malformationen stellen eine heterogene Gruppe seltener
Erkrankungen dar, die auf Fehlentwicklungen während der embryonalen und fetalen
Wachstumsphase basieren. Zu ihnen gehören der Trachealbronchus, die bronchiale
Atresie, die bronchogene Zyste, die Lungensequestration, das kongenitale lobäre
Emphysem sowie die sogenannte Congenital pulmonary Airway Malformation. Eines
der Leitsymptome dieser Malformationen ist die durch ihren verdrängenden Effekt
bedingte postnatale respiratorische Insuffizienz, welche eine rasche operative
Versorgung erfordert. Auch bei asymptomatischen Malformationen wird aufgrund des
erhöhten Infektrisikos die Resektion empfohlen.In der folgenden Übersicht wird auf die Ursachen, das klinische Bild und die
therapeutischen Optionen dieser angeborenen Fehlbildungen der Lunge und des
Bronchialsystems eingegangen.
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Affiliation(s)
- Birte Ohm
- Klinik für Thoraxchirurgie, Universitätsklinikum Freiburg, Medizinische
Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg,
Deutschland
| | - Wolfgang Jungraithmayr
- Klinik für Thoraxchirurgie, Universitätsklinikum Freiburg, Medizinische
Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg,
Deutschland
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10
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A 50-Year Old Woman With Recurrent Right-Sided Chest Pain. Chest 2022; 161:e85-e89. [DOI: 10.1016/j.chest.2021.08.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 08/15/2021] [Indexed: 11/30/2022] Open
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11
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Zarfati A, Voglino V, Tomà P, Cutrera R, Frediani S, Inserra A. Conservative management of congenital bronchial atresia: The Bambino Gesù children's hospital experience. Pediatr Pulmonol 2021; 56:2164-2168. [PMID: 33760393 DOI: 10.1002/ppul.25385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 03/01/2021] [Accepted: 03/10/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Congenital bronchial atresia (CBA) is a rare airway malformation. No management guidelines exist because of limited evidence: treatment, surgical or conservative, is based on consensus and opinion. OBJECTIVE To review the experience of a pediatric tertiary center and provide additional data about nonsurgical management of CBA and its outcomes after a structured follow-up, and to help formulate appropriate evidence-based guidelines. METHODS A retrospective analysis of clinical, radiological, surgical, and pathological data of all pediatric patients with suspicion of CBA referred to the surgical department of the Bambino Gesù children's hospital of Rome between December 2013 and 2019, along with a review of the literature. RESULTS Among the 18 children initially included in the study, 2 were lost to follow-up after radiological diagnosis, 4 underwent surgery for radiological suspicion of other pulmonary malformations. The final population is composed of 12 conservatively managed patients. At the end of the follow-up (median: 29 months, range 3-61), 1 patient (8%) was symptomatic. CONCLUSION Conservative management for CBA appears to be safe. Surgery should be reserved for patients with symptomatic or complicated cases.
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Affiliation(s)
- Angelo Zarfati
- General and Thoracic Pediatric Surgery Unit, Bambino Gesù' Children Hospital, Rome, Italy
| | - Valerio Voglino
- General and Thoracic Pediatric Surgery Unit, Bambino Gesù' Children Hospital, Rome, Italy
| | - Paolo Tomà
- Pediatric Radiology Unit, Bambino Gesù' Children Hospital, Rome, Italy
| | - Renato Cutrera
- Pediatric Broncopneumology, Bambino Gesù' Children Hospital, Rome, Italy
| | - Simone Frediani
- General and Thoracic Pediatric Surgery Unit, Bambino Gesù' Children Hospital, Rome, Italy
| | - Alessandro Inserra
- General and Thoracic Pediatric Surgery Unit, Bambino Gesù' Children Hospital, Rome, Italy
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12
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Hasenauer A, Forster C, Ojanguren A, Gonzalez M. Complex congenital lung malformation resection by uniportal VATS—case report. J Surg Case Rep 2021; 2021:rjab069. [PMID: 35070259 PMCID: PMC8777473 DOI: 10.1093/jscr/rjab069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 02/08/2021] [Indexed: 11/15/2022] Open
Abstract
Bronchial atresia (BA) is a rare congenital pulmonary airway malformation. It is characterized by the focal stenosis of a proximal segmental bronchus associated with peripheral mucus impaction and hyperinflation of the obstructed lung segment. Most cases are identified during neonatal period or childhood. When diagnosed in adults, BA may present with recurrent infections, pneumothorax and destruction of affected parenchyma. Thoracoscopic approach to BA has proved challenging in adult patients because of repeated infections and subsequently, its inflammatory status. Herein we present a case of a 26-year-old female with left side recurrent pneumonia and pneumothorax past history. A chest computed tomography revealed a complex congenital bronchial atresia involving the left upper lobe and basal segments, associated to vascular anomalies. She underwent a successful uniportal VATS left upper lobectomy and resection of basal segments. Uniportal VATS approach is an effective and safe treatment for the management of complex congenital lung malformation.
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Affiliation(s)
- Arpad Hasenauer
- Service of Thoracic Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - Céline Forster
- Service of Thoracic Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - Amaya Ojanguren
- Service of Thoracic Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - Michel Gonzalez
- Service of Thoracic Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
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Puglia EBMD, Rodrigues RS, Daltro PA, Souza AS, Paschoal MM, Labrunie EM, Irion KL, Hochhegger B, Zanetti G, Marchiori E. Tomographic findings in bronchial atresia. Radiol Bras 2021; 54:9-14. [PMID: 33574627 PMCID: PMC7863713 DOI: 10.1590/0100-3984.2019.0136] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective To evaluate computed tomography (CT) findings in 23 patients with bronchial atresia. Materials and Methods The CT images were reviewed by two radiologists who reached decisions by consensus. We included only patients who presented with abnormalities on CT and in whom the diagnosis had been confirmed by pathological examination of the surgical specimen (if the lesion was resected). The CT scans were assessed in order to identify the main findings and to map the distribution of the lesions (i.e., to determine whether the pulmonary involvement was unilateral or bilateral). Results The main CT finding was the combination of bronchocele and hyperinflation of the distal lung. That combination was observed in all of the patients. The lesions were unilateral in all 23 cases, being seen predominantly in the left upper lobe, followed by the right lower lobe, right upper lobe, middle lobe, and left lower lobe. Conclusion The diagnosis of bronchial atresia can be reliably made on the basis of a finding of bronchocele accompanied by hyperinflation of the adjacent lung parenchyma.
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Affiliation(s)
- Elazir Barbosa Mota Di Puglia
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.,Clínica de Diagnóstico por Imagem (CDPI), Rio de Janeiro, RJ, Brazil
| | - Rosana Souza Rodrigues
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.,Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, RJ, Brazil
| | | | - Arthur Soares Souza
- Faculdade de Medicina de São José do Rio Preto (Famerp), São José do Rio Preto, SP, Brazil
| | | | | | | | - Bruno Hochhegger
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Gláucia Zanetti
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Edson Marchiori
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
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14
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Kuwabara G, Sone R, Imoto W, Yamairi K, Shibata W, Oshima K, Yamada K, Yamada K, Watanabe T, Asai K, Komatsu H, Izumi N, Nishiyama N, Kawaguchi T, Kakeya H. Congenital bronchial atresia complicated by a lung abscess due to Aspergillus fumigatus: a case report. BMC Pulm Med 2021; 21:2. [PMID: 33407289 PMCID: PMC7788814 DOI: 10.1186/s12890-020-01367-5] [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: 08/28/2020] [Accepted: 12/03/2020] [Indexed: 11/21/2022] Open
Abstract
Background Congenital bronchial atresia is a rare pulmonary abnormality characterized by the disrupted communication between the central and the peripheral bronchus and is typically asymptomatic. Although it can be symptomatic especially when infections occur in the involved areas, fungal infections are rare complications in patients with bronchial atresia. We report a case of congenital bronchial atresia complicated by a fungal infection.
Case presentation A 30-year-old man with no previous history of immune dysfunction was brought to a nearby hospital and diagnosed with a left lung abscess. Although antimicrobial treatment was administered, it was ineffective, and he was transferred to our hospital. Since diagnostic imaging findings and bronchoscopy suggested congenital bronchial atresia and a fungal infection, he was treated with voriconazole and surgical resection was subsequently performed. A tissue culture detected Aspergillus fumigatus and histopathological findings were compatible with bronchial atresia. After discharge, he remained well and voriconazole was discontinued 5 months after the initiation of therapy. Conclusion Bronchial atresia is a rare disease that is seldom complicated by a fungal infection, which is also a rare complication; however, physicians should consider fungal infections in patients with bronchial atresia who present with infections resistant to antimicrobial treatment.
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Affiliation(s)
- Gaku Kuwabara
- Department of Infection Control Science, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan.,Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan
| | - Risa Sone
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan
| | - Waki Imoto
- Department of Infection Control Science, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan.,Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan
| | - Kazushi Yamairi
- Department of Infection Control Science, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan
| | - Wataru Shibata
- Department of Infection Control Science, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan
| | - Kazuhiro Oshima
- Department of Infection Control Science, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan
| | - Koichi Yamada
- Department of Infection Control Science, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan
| | - Kazuhiro Yamada
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan
| | - Tetsuya Watanabe
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan
| | - Kazuhisa Asai
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan
| | - Hiroaki Komatsu
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan
| | - Nobuhiro Izumi
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan
| | - Noritoshi Nishiyama
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan
| | - Tomoya Kawaguchi
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan
| | - Hiroshi Kakeya
- Department of Infection Control Science, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan.
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15
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Murata S, Oguri T, Sasada S, Tsuchiya Y, Ishioka K, Takahashi S, Kuriyama S, Kaji M, Seki R, Hirose S, Nakamura M. A case of congenital bronchial atresia patient with subclinical infection who underwent lung resection. Respir Med Case Rep 2020; 30:101076. [PMID: 32420019 PMCID: PMC7218211 DOI: 10.1016/j.rmcr.2020.101076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 05/05/2020] [Indexed: 11/17/2022] Open
Abstract
Congenital bronchial atresia, CBA, is rare and has often asymptomatic benign condition. The CBA condition usually arose during the formation of bronchi, but the CBA patients are able to live well into adulthood. This case highlights a potential surgical intervention for a CBA patient with subclinical infection. A 55-year-old Japanese male had abnormal findings on his chest X-ray at an annual health check-up in March 2018. His chest computed tomography (CT) revealed bronchial stenosis and infiltrative shadow in the right inferior lobe. He was referred to our hospital for further investigation and was diagnosed CBA after a variety of examinations including bronchoscopy. His dilated bronchi were filled with mucus, the end of one of the bronchi had obstructive pneumonia, and subclinical infection in the CBA lesion was suspected. Also, the result of bronchoscopy disclosed intrabronchial infection with Gram-positive bacteria so we performed lobectomy onto the lower lobe. Although no protocol had been established, a surgical intervention would be necessary for this case.
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Affiliation(s)
- Saori Murata
- Department of Respiratory Medicine, Tokyo Saiseikai Central Hospital, Japan
| | - Tomoyo Oguri
- Department of Respiratory Medicine, Tokyo Saiseikai Central Hospital, Japan
| | - Shinji Sasada
- Department of Respiratory Medicine, Tokyo Saiseikai Central Hospital, Japan
| | - Yumi Tsuchiya
- Department of Respiratory Medicine, Tokyo Saiseikai Central Hospital, Japan
| | - Kota Ishioka
- Department of Respiratory Medicine, Tokyo Saiseikai Central Hospital, Japan
| | - Saeko Takahashi
- Department of Respiratory Medicine, Tokyo Saiseikai Central Hospital, Japan
| | - Shoji Kuriyama
- Department of Thoracic Surgery, Tokyo Saiseikai Central Hospital, Japan
| | - Masahiro Kaji
- Department of Thoracic Surgery, Tokyo Saiseikai Central Hospital, Japan
| | - Reishi Seki
- Department of Diagnostic Pathology, Tokyo Saiseikai Central Hospital, Japan
| | - Shigemichi Hirose
- Department of Diagnostic Pathology, Tokyo Saiseikai Central Hospital, Japan
| | - Morio Nakamura
- Department of Respiratory Medicine, Tokyo Saiseikai Central Hospital, Japan
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16
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Masroujeh R, Young B. Endobronchial Treatment of Bronchial Atresia. Am J Respir Crit Care Med 2020; 200:e25-e26. [PMID: 30860860 DOI: 10.1164/rccm.201806-1169im] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Ramy Masroujeh
- Pulmonary Critical Care and Sleep Medicine, University Hospitals, Cleveland Medical Center, Cleveland, Ohio
| | - Benjamin Young
- Pulmonary Critical Care and Sleep Medicine, University Hospitals, Cleveland Medical Center, Cleveland, Ohio
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17
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Alebna PA, Kim DH, Chaudhary R, Tavares M. Pulmonary hypertension and congenital bronchial atresia: A time factor association. Respir Med Case Rep 2019; 28:100882. [PMID: 31297310 PMCID: PMC6597737 DOI: 10.1016/j.rmcr.2019.100882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 06/11/2019] [Accepted: 06/11/2019] [Indexed: 12/19/2022] Open
Abstract
Congenital bronchial atresia is rarely symptomatic in adults. Recurrent lung infection and pneumothorax are the feared complications of this otherwise benign condition. The objective of this article is to present a case of congenital bronchial atresia manifesting as pulmonary hypertension in a 66 year-old patient. While doing so, we highlight the relevant knowledge accrued in medical literature with regards this rare condition. Finally, with the revelation that congenital bronchial atresia may cause severe pulmonary hypertension later in life, perhaps a less conservative approach to management may be warranted in younger adults and children with this condition.
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Affiliation(s)
| | - David H. Kim
- George Washington University, Washington, DC, United States
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18
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Nair VV, Narayan KV, Nair JTK. "Not all bullae are synonymous with COPD"-a rare congenital anomaly described. Indian J Thorac Cardiovasc Surg 2019; 35:89-90. [PMID: 33060980 DOI: 10.1007/s12055-018-0715-2] [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: 06/16/2018] [Revised: 07/04/2018] [Accepted: 07/16/2018] [Indexed: 11/28/2022] Open
Abstract
Hyperlucent areas with thin walls and absent vascular markings in chest X ray are described as radiological findings of a bullae. We present the case of an adult male referred for coronary revascularisation and bullectomy in the right lung. A non-smoker, without any significant past medical history, made us think of bronchial atresia. He was planned for coronary artery bypass grafting with close follow-up of lung anomaly. Clinicians should be aware of this entity in non-smokers with unilateral bullous lesion and calcification as other close clinical differentials warrant aggressive medical management.
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19
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Narayan RR, Abadilla N, Greenberg DR, Sylvester KG, Hintz SR, Barth RA, Bruzoni M. Predicting Pathology From Imaging in Children Undergoing Resection of Congenital Lung Lesions. J Surg Res 2018; 236:68-73. [PMID: 30694781 DOI: 10.1016/j.jss.2018.10.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 09/18/2018] [Accepted: 10/25/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Prenatal magnetic resonance imaging (MRI) is increasingly obtained to define congenital lung lesions (CLL) for surgical management. Postnatal, preoperative computed tomography (CT) provides further clarity at the cost of radiation. Depending on the lesion identified, the indication for resection remains controversial. We investigated the differences in detail found on prenatal MRI and postnatal CT compared with final pathology to determine their utility in preoperative decision-making. MATERIALS AND METHODS All children undergoing resection of CLLs at a single institution between July 2009 and February 2018 were retrospectively identified. Their imaging, operative, and pathology reports were compared. All imaging studies were examined by pediatric radiologists with experience in prenatal CLL diagnosis. RESULTS Fifty-five patients underwent CLL resection during the study period with 31 undergoing prenatal MRI, 45 postnatal CT, and 22 both. Resection was performed before 6 mo of age in 62% of patients. In the cohort undergoing both imaging studies, pathologic CLL diagnosis correlated with prenatal MRI and CT in 82% and 100% of patients, respectively (P = 0.13). Eight patients had systemic feeding vessels, of which 38% were identified on MRI, and 88% on CT (P = 0.13). Both studies had a specificity of 100% for detecting systemic feeding vessels. CONCLUSIONS For children where prenatal MRI detected a systemic feeding vessel, CT was redundant for preoperative planning but had greater sensitivity. Ultimately, the CLL type predicted from postnatal CT was not significantly different from that predicted by prenatal MRI; however, both imaging modalities had some level of discrepancy with pathology.
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Affiliation(s)
- Raja R Narayan
- Division of Pediatric Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Natasha Abadilla
- Division of Pediatric Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Daniel R Greenberg
- Division of Pediatric Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Karl G Sylvester
- Division of Pediatric Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Susan R Hintz
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Richard A Barth
- Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - Matias Bruzoni
- Division of Pediatric Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California.
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20
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Sabri YY, Hafez MA, Assal HAH, Al-Dura MA. Emphasizing the role of multi-detector computed tomography chest in the etiological diagnosis of pulmonary bronchiectasis. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2018. [DOI: 10.1016/j.ejrnm.2018.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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21
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Garcia-Reina S, Fernández E, Martinez-Barenys C, López de Castro P. Incidental diagnosis of bronchial atresia after chest trauma. Arch Bronconeumol 2018; 55:53-54. [PMID: 29803522 DOI: 10.1016/j.arbres.2018.03.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 03/14/2018] [Accepted: 03/15/2018] [Indexed: 10/16/2022]
Affiliation(s)
- Samuel Garcia-Reina
- Departamento de Cirugía Torácica, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España.
| | - Esther Fernández
- Departamento de Cirugía Torácica, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | - Carlos Martinez-Barenys
- Departamento de Cirugía Torácica, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | - Pedro López de Castro
- Departamento de Cirugía Torácica, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
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22
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Saadé-Yordán C, McBurney-Henriquez E, González-Santoni R, Gurrea-Rosas C, Montalvo-Fitzpatrick J, Maldonado-Vargas JA. Marked 18-Fuorine-Fluorodeoxyglucose (FDG) Avidity of an Intrapulmonary Typical Carcinoid Tumor Manifesting as a Bronchocele in an Asymptomatic Middle-Aged Woman. AMERICAN JOURNAL OF CASE REPORTS 2017; 18:1390-1395. [PMID: 29282351 PMCID: PMC5753618 DOI: 10.12659/ajcr.906678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Patient: Female, 67 Final Diagnosis: Pulmonary carcinoid tumor Symptoms: Abnormal shadow on Chest X-ray Medication: — Clinical Procedure: Surgery – left upper lobe lobectomy Specialty: Radiology
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Affiliation(s)
- Camila Saadé-Yordán
- Department of Diagnostic Radiology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
| | - Edward McBurney-Henriquez
- Department of Diagnostic Radiology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
| | - Ricardo González-Santoni
- Department of Family Medicine, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
| | - Carmen Gurrea-Rosas
- Department of Pathology, Cardiovascular Center of Puerto Rico and The Caribbean, San Juan, Puerto Rico
| | - José Montalvo-Fitzpatrick
- Department of Cardiothoracic Surgery, Cardiovascular Center of Puerto Rico and The Caribbean, San Juan, Puerto Rico
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23
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Muglia C, Oppenheimer J. Wheezing in Infancy: An Overview of Recent Literature. Curr Allergy Asthma Rep 2017; 17:67. [PMID: 28895039 DOI: 10.1007/s11882-017-0737-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE OF REVIEW Wheezing in infancy is a common presentation with many potential causes. In writing this review, we sought to summarize the newest recommendations and testing available for the more common etiologies of wheezing. RECENT FINDINGS Regarding the diagnosis of asthma, the modified asthma predictive index has recently been established as a useful predictive tool. Non-breath held multidetector CT with 3D volume rendering airway images is also a newer helpful diagnostic tool for tracheomalacia due to ease of use and its 100% positive predictive value. We found vaccines have greatly reduced the prevalence of epiglottitis, while advances in surgery are improving outcomes in infants with vascular rings. Wheezing in infants is a common problem with an extensive differential diagnosis from relatively benign to life threatening. To prevent over-looking a diagnosis that potentially requires surgical correction or emergent care, we recommend a structured approach to the history and physical exam with targeted testing directed towards the most likely diagnoses as outlined in this review.
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Affiliation(s)
- Christine Muglia
- Rutgers New Jersey Medical School, The State University of New Jersey, 90 Bergen Street, Newark, NJ, 07103, USA
| | - John Oppenheimer
- Rutgers New Jersey Medical School, The State University of New Jersey, 90 Bergen Street, Newark, NJ, 07103, USA.
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24
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Keng LT, Liang SK. Bronchial atresia. QJM 2017; 110:47-48. [PMID: 28115680 DOI: 10.1093/qjmed/hcw178] [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: 08/30/2016] [Revised: 09/18/2016] [Indexed: 11/12/2022] Open
Affiliation(s)
- L-T Keng
- Department of Internal Medicine, Nation Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan.
| | - S-K Liang
- Department of Internal Medicine, Nation Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
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25
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Yu G, Xia B, Wang Z, Huang B, Zhang Y, Hong C, Shang N, Tang J. Prenatal and postnatal management of congenital bronchial atresia (CBA): single tertiary center report. J Matern Fetal Neonatal Med 2016; 30:2006-2010. [PMID: 27628315 DOI: 10.1080/14767058.2016.1236083] [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] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To summarize our diagnosis and management experience of congenital bronchial atresia (CBA). METHODS A retrospective review was conducted, clinical data were collected of all patients with CBA. RESULTS Among the nine patients (5 males and 4 females), six cases with right side and three cases with left cases, including one patient with mainstem bronchial atresia (MBA), two cases with lobar bronchial atresia (LBA), six cases with segmental bronchial atresia (SBA). Eight were diagnosed as congenital cystic adenomatoid malformation (CCAM) type III by ultrasound (US) in prenatal. The MBA patient was diagnosed by computed tomography (CT) and bronchofibroscopy, only two patients by pathological findings and the other six patients by CT. Five cases were accompanied by CCAM, one case with bronchopulmonary sequestration (BPS), two cases with emphysema. Eight cases except MBA were underwent thoracoscopic surgery treatment and had favorable prognosis. Two cases with LBA merged with complication of pectus excavatum after surgery. One case with MBA had no surgery and died in the 13 days old. CONCLUSIONS CBA is an easily misdiagnosed disease from pathologic conditions, definitive diagnosis of this condition depends on combination CT or clinical pathologic diagnosis. Thoracoscopic resection is a safe and feasible treatment of CBA in experienced hands.
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Affiliation(s)
- Gang Yu
- a Department of Maternal-Fetal Medicine , Guangdong Women and Children Hospital , Guangzhou , China
| | - Bo Xia
- a Department of Maternal-Fetal Medicine , Guangdong Women and Children Hospital , Guangzhou , China
| | - Zhu Wang
- a Department of Maternal-Fetal Medicine , Guangdong Women and Children Hospital , Guangzhou , China
| | - Baisha Huang
- a Department of Maternal-Fetal Medicine , Guangdong Women and Children Hospital , Guangzhou , China
| | - Ying Zhang
- a Department of Maternal-Fetal Medicine , Guangdong Women and Children Hospital , Guangzhou , China
| | - Chun Hong
- a Department of Maternal-Fetal Medicine , Guangdong Women and Children Hospital , Guangzhou , China
| | - Ning Shang
- a Department of Maternal-Fetal Medicine , Guangdong Women and Children Hospital , Guangzhou , China
| | - Jing Tang
- a Department of Maternal-Fetal Medicine , Guangdong Women and Children Hospital , Guangzhou , China
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26
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Karaman S, Deveci R, Erdem SB, Karkıner A, Alper H, Can D. Unusual Radiological Sign in Bronchial Atresia. Turk Thorac J 2016; 17:79-81. [PMID: 29404129 DOI: 10.5578/ttj.17.2.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 08/31/2015] [Indexed: 12/17/2022]
Abstract
Bronchial atresia is usually diagnosed by incidentally detecting opacitiy at hilar ragion and hyperinflation around this opacity on chest X-ray. It may rarely be detected as air sac like atresic bronchus. The breath sounds in the right hemithorax were heard less when compared to the left hemithorax in the auscultation of a 16-year-old male patient with allergic rhinitis. The patient had no pulmonary complaints, and this finding was not recorded in his previous follow-up. In order to determine the etiology of hyperinflation seen on chest X-ray, computed tomography was performed. Hyperinflation was identified in the lower lobe superior segment of the right lung, which could be secondary to bronchial atresia. It was confirmed that in the evaluation of computed tomography with three-dimensional reconstruction, lower lobe superior segment bronchus of the right lung was atresic and contrary to expected mucus opacity in the distal of atresia, dilated bronchus was filled with air. This case was especially presented to lay emphasis on careful auscultation and share its unusual radiological presentation which had been reported twice before.
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Affiliation(s)
- Sait Karaman
- Clinic of Allergy and Immunology, Dr. Behçet Uz Children Diseases and Surgery Training and Research Hospital, İzmir, Turkey
| | - Reyhan Deveci
- Clinic of Allergy and Immunology, Dr. Behçet Uz Children Diseases and Surgery Training and Research Hospital, İzmir, Turkey
| | - Semiha Bahçeci Erdem
- Clinic of Allergy and Immunology, Dr. Behçet Uz Children Diseases and Surgery Training and Research Hospital, İzmir, Turkey
| | - Aytaç Karkıner
- Clinic of Allergy and Immunology, Dr. Behçet Uz Children Diseases and Surgery Training and Research Hospital, İzmir, Turkey
| | - Hüdaver Alper
- Department of Radiology, Division of Children Radiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Demet Can
- Clinic of Allergy and Immunology, Dr. Behçet Uz Children Diseases and Surgery Training and Research Hospital, İzmir, Turkey
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27
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Mehta AC, Thaniyavarn T, Ghobrial M, Khemasuwan D. Common Congenital Anomalies of the Central Airways in Adults. Chest 2015; 148:274-287. [PMID: 25811532 DOI: 10.1378/chest.14-1788] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
The knowledge of airway anatomy is the most fundamental requirement of every bronchoscopist. There are numerous and frequent anatomic variations of the central airways making the examination unique for every individual. It is imperative for every bronchoscopist to be fully cognizant of the common congenital anomalies involving the central airways. Proper identification and reporting of these findings are a matter of the utmost importance, especially when surgical options in a patient with lung cancer or lung transplantation is under consideration. This article focuses on the congenital anomalies of central airway encountered among adults. Each of these anatomic variations has a characteristic appearance, yet requires bronchoscopic acumen for their identification. This review provides a comprehensive description of these anomalies and highlights their clinical implications.
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Affiliation(s)
- Atul C Mehta
- Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH.
| | - Tany Thaniyavarn
- Department of Pulmonary, Allergy, and Critical Care Medicine, Emory University, Atlanta, GA
| | - Michael Ghobrial
- Internal Medicine Department, Fairview Hospital, a Cleveland Clinic Hospital, Cleveland, OH
| | - Danai Khemasuwan
- Interventional Pulmonary Medicine, Henry Ford Hospital, Detroit, MI
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28
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Abstract
OBJECTIVE Recent technical advances, including the routine use of CT thin sections and techniques such as 2D minimum-intensity-projection and 3D volume images, have increased our ability to detect large airways diseases. Furthermore, dedicated CT protocols allow the evaluation of dynamic airway dysfunction. CONCLUSION With diseases of the large airways more commonly seen in daily practice, it is important that radiologists be familiar with the appearances, differential diagnosis, and clinical implications of these entities.
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29
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Abstract
Antenatal detection of congenital pulmonary airway malformations (CPAM) has improved immeasurably from its initial application in the 1980s and probably encompasses >80% of all such lesions. Accurate diagnosis still remains less reliable and definitive diagnosis requires detailed anatomical imaging (typically with CT scan) in the post-natal period. About 10% of all lesions will present with symptoms during the neonatal period and the choice of surgical intervention is then easy. For those that remain asymptomatic then there is still a degree of controversy about elective surgical resection. This article presents the case for elective surgery within the first year of life and aims to quantify the risks of non-intervention such as abscess, empyema, recurrent pneumonia, air-leak, and pneumothorax and various types of malignancy in such cases. The current surgical approach now includes both open muscle-sparing thoracotomy and thoracoscopic resection.
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Affiliation(s)
- Rashmi Singh
- Department of Paediatric Surgery, King׳s College Hospital, Denmark Hill, London SE5 9RS, UK
| | - Mark Davenport
- Department of Paediatric Surgery, King׳s College Hospital, Denmark Hill, London SE5 9RS, UK.
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30
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Panigrahi MK, Saka VK. Congenital bronchial atresia misdiagnosed as pulmonary tuberculosis. J Postgrad Med 2015; 61:209-10. [PMID: 26119444 PMCID: PMC4943401 DOI: 10.4103/0022-3859.159428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- M K Panigrahi
- Department of Pulmonary Medicine, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
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31
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Ray A. Extensive unilateral pulmonary tuberculosis with segmental atresia of principal bronchus. Lung India 2015; 32:95. [PMID: 25624617 PMCID: PMC4298940 DOI: 10.4103/0970-2113.148471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Animesh Ray
- Department of Pulmonary Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjang Hospital, New Delhi, India. E-mail:
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32
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Waring T, Delivanis D, Kaloudis E, Datta D. A 46-year-old woman with persistent asthma and lung masses. Chest 2014; 145:1166-1169. [PMID: 24798843 DOI: 10.1378/chest.13-2208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Affiliation(s)
- Thomas Waring
- Department of Pulmonary and Critical Care Medicine, University of Connecticut Health Center, Farmington, CT
| | - Danae Delivanis
- Department of Internal Medicine, University of Connecticut Health Center, Farmington, CT
| | - Electra Kaloudis
- Department of Radiology, University of Connecticut Health Center, Farmington, CT
| | - Debapriya Datta
- Department of Pulmonary and Critical Care Medicine, University of Connecticut Health Center, Farmington, CT.
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