Bronchial atresia: the hidden pathology within a spectrum of prenatally diagnosed lung masses

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• 作者：Shaun M. Kunisaki ; Dario O. Fauza ; Luanne P. Nemes ; Carol E. Barnewolt ; Judy A. Estroff ; Harry P. Kozakewich ; Russell W. Jennings
• 刊名：Journal of Pediatric Surgery
• 出版年：2006
• 出版时间：January 2006
• 年：2006
• 卷：41
• 期：1
• 页码：61-65
• 全文大小：236 K

文摘

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.