Author(s): Kunisaki SM, Fauza DO, Nemes LP, Barnewolt CE, Estroff JA,
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Abstract PURPOSE: This study was aimed at determining whether different congenital lung masses represent diverse manifestations of a single developmental abnormality associated with fetal airway obstruction. METHODS: We conducted a 3-year retrospective review of patients who underwent surgical resection of a prenatally diagnosed lung mass. Prenatal imaging was used to define mass position and its effect on adjacent organs. Lung specimens were examined through careful full-specimen microdissections, as well as by plain and contrast roentgenograms. RESULTS: Twenty-five patients underwent lung resection during this study period. Based on the final pathology reports, 56\% were congenital cystic adenomatoid malformations, 12\% were congenital lobar emphysemas, 8\% were bronchopulmonary sequestrations, and 24\% had features of both cystic adenomatoid malformation and bronchopulmonary sequestrations. No bronchogenic cysts were present in this series. Overall, bronchial atresia was identified in 77\% of the examined specimens (n = 22) and was associated with all types of lung malformations. CONCLUSIONS: Bronchial atresia is a common, unrecognized component of prenatally diagnosed congenital cystic adenomatoid malformations, bronchopulmonary sequestrations, congenital lobar emphysemas, and lesions of mixed pathology. Most congenital lung masses may be part of a spectrum of anomalies linked to obstruction of the developing fetal airway as an underlying component in their pathogenesis.
This article was published in J Pediatr Surg
and referenced in Journal of Addiction Research & Therapy