Congenital Lobar Emphysema

Cottom, Dennis; Myers, N. A.

doi:10.1136/bmj.1.5032.1394

Cited by 30 publications

(14 citation statements)

References 3 publications

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“…The most common cause of vesicular, non-congenital emphysema in lung tissue is bronchial obstruction as a result of chronic bronchitis or aspiration of a foreign body (Cottom and Meyers 1957). Inspired air is held back during expiration through a valve effect, causing pressure to build up in parts of the lung tissue (Cottom and Meyers 1957). Simply increasing pressure in the alveolar tissue of normal lungs does not result in emphysema or other similar pathological findings in dogs (Anderson and others 1964).…”

Section: Discussionmentioning

confidence: 99%

Bronchogenic cyst in a German shepherd dog

Dahl¹,

Rorvik

Lanageland

2002

J of Small Animal Practice

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Intermittent episodes of fever, severe dyspnoea and cyanosis were observed in a two-and-a-half-year-old male German shepherd dog. The clinical signs were of sudden onset but disappeared within eight hours, in five almost identical episodes over a period of 40 days. Radiological examination of the thorax revealed a large rounded area of radiolucency surrounded by a thin radiopaque structure. The lesion increased in volume between examinations, but otherwise remained similar in appearance. It could not be confirmed from the radiographs whether the structure was situated in lung tissue or mediastinum. Bronchoscopic examination revealed no abnormal findings and there was no bacterial growth from samples taken 30 days after the onset of symptoms. A large, vesicular structure, partly adherent to the mediastinum, was surgically removed from the left cranial lung lobe. The structure was 8 to 10 cm in diameter and partly filled with mucoid pink fluid. Histological examination revealed that the wall contained traces of bronchial epithelial cells. On bacteriological examination of the fluid, Gram-positive, mucus-forming bacteria were present. The definitive gross pathological and histopathological diagnosis was a bronchogenic cyst which had developed secondarily to bronchiectasis. Bronchitis and peribronchitis were also identified. The dog recovered well after surgery and, at the time of writing, was in active duty as a police dog, showing no signs of respiratory illness.

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Section: Discussionmentioning

confidence: 99%

Bronchogenic cyst in a German shepherd dog

Dahl¹,

Rorvik

Lanageland

2002

J of Small Animal Practice

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“…In another an abnormal vein or artery was thought to have produced the same effect (Contro, Miller, White, and Potts, 1958a and b). In other series, where the emphysema involved the right middle lobe, it could not be attributed to mechanical obstruction (Cottom and Myers, 1957;Jones et al, 1965). It may be that in these cases the emphysema is hypoplastic.…”

Section: The Present Casementioning

confidence: 91%

New pathological findings in emphysema of childhood: 3. Unilateral congenital emphysema with hypoplasia--and compensatory emphysema of contralateral lung

Henderson

Hislop

Reid

1971

Thorax

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A quantitative study is here reported on the lungs of a child of 9 months with unilateral emphysema associated with hypoplasia, and with compensatory emphysema in the contralateral lung. The left lung was judged to show congenital hypoplasia because of the reduced number of bronchi and arteries, its small volume, and a total alveolar number less than that normally found at birth. This last was due mainly to reduction in the number of acini, the intra-acinar number seeming little affected. As the alveoli were eight times the normal volume, the case was considered to be one of congenital hypoplastic emphysema.The right lung was evidently normal at birth, since it had a normal number of bronchi, arteries, and alveoli. The lung was increased in volume due to an increase in alveolar volume-an example of compensatory emphysema.This case is discussed with relation to two previously reported cases of lobar emphysema and other cases in the literature. It is emphasized that a quantitative analysis of the state of bronchi, alveoli, and blood vessels is important to establish the nature of the pathological change. A preliminary classification based on the anatomical features is offered.The degree of growth of airways, alveoli, and arteries in cases of childhood lobar emphysema has recently been assessed quantitatively. In one case the condition was due to a 'polyalveolar' lobe (Hislop and Reid, 1970) and in another to overinflation of a normally developed lobe . In the first paper (Hislop and Reid, 1970) This baby was born on 17 March, 1965. She had a cleft lip and anterior palate. She was seen at 6 months for repair of the lip but only a limited repair was considered possible because of her poor physical condition. At this time she was thought to have an enlarged left ventricle with a loud systolic murmur at the left sternal edge together with a murmur at the apex interpreted as being due to increased blood flow.The radiograph on 3 September, 1965 ( Fig. 1) was in partial expiration, the left dome being low compared with the right, suggesting air trapping in the left lung, although the heart was not displaced: the left lung was hypertransradiant and avascular, these changes being least marked in the medial part of the left upper lobe where the blood flow seemed better but still not normal. The right lung was plethoric, the heart and pulmonary trunk enlarged, and the aortic knuckle small. The apical lower lobe was partially collapsed. Angiography confirmed that the vessels to the right lung were enlarged with dilatation and tortuosity mainly of the proximal intrapulmonary vessels. No medium entered the left lung; an infracristal septal defect was seen.

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“…They usually consist of anomalies of the cartilage rings -absence, hypoplasia or abnormal softness (bronchomalacia). A survey of the literature shows that these anomalies have been described by Overstreet (1939), Fischer et al (1952), Shaw (1952), Sloan (1953), Bolande, Schneider, and Boggs (1956), Holzel, Bennett, and Vaughan (1956), Mathey, Binet, and Galey (1956), Cottom and Myers (1957), Nelson, T. Y. (1957), Stovin (1959), andMoyson, Desmul, andCremer (1962).…”

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confidence: 98%

“…External compression of a main bronchus or a lobar bronchus may have a vascular cause: patent ductus arteriosus (Fischer et al, 1952-2 out of 6 cases; Bolande et al, 1956;Cottom and Myers, 1957); aneurysm of a pulmonary vein (Robertson and James, 1951); or an abnormal pulmonary artery (Potts, Holinger, and Rosenblum, 1954;Morse and Gladding, 1955;Belsey, 1958;Contro, Miller, White, and Potts, 1958a,b;Sherman, 1959). Cottom and Myers (1957) reported a congenital heart defect in four out of six cases of lobar emphysema.…”

mentioning

confidence: 99%

Bronchial atresia with corresponding segmental pulmonary emphysema

Lk¹,

Fornhoff²,

Dierickx³

et al. 1971

Thorax

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This paper presents a 13-year-old boy suffering from congenital bronchial atresia of the anterior and apicoposterior segments of the left upper lobe with corresponding emphysema, and emphysema with bronchial atresia in the anterobasal segment of the left lower lobe. The aetiology of congenital localized emphysema is not always clear. In the group with a demonstrable check-valve mechanism, which permits air to enter but not to leave the lung, there is either internal stenosis or external compression of the bronchus. The condition is called idiopathic if no cause can be identified, but in some of these cases microscopical examination has disclosed alveolar fibrosis which prevents the rigid alveoli from collapsing on expiration. In these cases the check-valve mechanism exists at an alveolar level. In the small group of rare cases of bronchial atresia, air which enters through a collateral ventilation cannot be expired by the same route, and in these cases there is likewise a check-valve mechanism at an alveolar level; this is associated wiith the occurrence of localized emphysema, characterized by the presence of normal bronchial ramifications which arise from a bronchial sac with a blind proximal ending. The bronchial atresia is believed to occur after the 15th week of intrauterine life, probably as a result of vascular insufficiency. A preoperative diagnosis is possible on the basis of a plain chest radiograph, which shows the localized emphysema as well as an abnormal hilus shadow representing the mucus-filled blind bronchial stump; the diagnosis can be established also by a bronchogram, which shows a filling defect in the affected part of the lung. Surgical treatment is indicated.Congenital pulmonary emphysema is a condition with which paediatricians and thoracic surgeons are now familiar. Nelson (1932) was the first to focus attention on the serious nature of this condition in infants, in a report on a fatal case which occurred in a child aged 5 5 months. Royes (1938) was the first to mention localized lobar emphysema in an adult; its cause was partial bronchial obstruction by a mucosal flap, an incidental finding at postmortem examination of an accident victim without pulmonary complaints. Overstreet (1939) focused attention on an anomaly of the lobar cartilage in a case of lobar emphysema. Gross and Lewis (1945) described the first patient with infantile lobar emphysema, who was successfully treated by lobectomy.Numerous cases of localized emphysema have since been described, usually in infants with acute respiratory disorders. Raynor, Capp, and Sealy (1967) and Murray (1967) report series of 120 and 'Present address:

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Congenital Lobar Emphysema

Cited by 30 publications

References 3 publications

Bronchogenic cyst in a German shepherd dog

Bronchogenic cyst in a German shepherd dog

New pathological findings in emphysema of childhood: 3. Unilateral congenital emphysema with hypoplasia--and compensatory emphysema of contralateral lung

Bronchial atresia with corresponding segmental pulmonary emphysema

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