Congenital bronchopulmonary foregut malformations: concepts and controversies

Abstract

This article addresses the scope, etiology, important associations and imaging features of congenital bronchopulmonary foregut malformations. Etiologic concepts, including airway obstruction and vascular anomalies, are highlighted. Technical imaging advances, especially CT and MR, have greatly enhanced our diagnostic abilities in evaluating these lesions; however, thorough and careful assessment of all aspects of the malformation is still necessary. Several specific lesions are discussed in more detail, particularly regarding controversial issues in classification, understanding, imaging and management.

Congenital bronchopulmonary malformation: CT histopathological correlation

“…In 75% cases (18 out of 24) cases the areas of hypoattenuation were present ( Fig. 1) which correspond with the findings reported 2,5,8,9 . In 50% cases (12 out of 24) the areas of hypoattenuation occurred together with another type of BPMs, with three bronchopulmonary sequestrations, all being type 1 CPAMs, and with four sequestrations of type 2 CPAMs, which is an additional CT characteristic of the lesion.…”

“…The advent of prenatal US and MRI has considerably increased the prenatal diagnosis of lung pathologies but complete characterization remains difficult. In utero airway maldevelopment with resultant obstruction is a recurrent proposed aetiology for many of these lesions, especially those associated with hyperlucent or cystic lung changes 2 . This causes even more confusion in terms of how these malformations should be described 3 .…”

“…There is now even more confusion as to how these malformations should be described 3 . Therefore we, like some other autors [1][2][3] , prefer to describe radiological findings thoroughly rather than try to categorize lesions in terms of pathologic terminology only. From a radiologist's point of view it is essential to realize what is actually seen on a CT image and what should be recorded without the undertone of embryological speculation.…”

Esophageal Atresia with Bronchogenic Cyst

“…이는 태생 5-7주 사 이에 원시 전장(primitive foregut)이 기도와 식도로 완전히 분리되지 않아 나타나는 기관지폐 전장 기형(bronchopulmonary foregut malformation) 범주의 선천기형 중 하나 로, 기관지 낭종(bronchogenic cyst), 식도 낭종, 식도폐쇄 (esophageal atresia, EA), 기관식도루(tracheoesophageal fistula, TEF), 기관식도게실, 기관식도협착 등도 같은 발생 학적 기전으로 설명할 수 있다 [3][4][5].…”

Congenital Malformations and Developmental Anomalies of the Lung

“…Congenital anomalies may exhibit varied appearances [19][20][21]-like focal hyperlucency, presence of fluid or air-filled cystic (or solid-appearing) lesions, vascular anomaly, airway abnormality or thoracic asymmetry. Radiographic differential diagnosis of few common CLM is given in Table 2.…”