Congenital lung lesions: Postnatal management and outcome

Parikh, Dakshesh; Rasiah, SV

doi:10.1053/j.sempedsurg.2015.01.013

Cited by 63 publications

(44 citation statements)

References 63 publications

(81 reference statements)

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“…We believe, in accordance with several authors [7,9,16,18], that elective resection in asymptomatic infants is advised to prevent postnatal complications, such as chest infections and sepsis -the risk of infection for congenital PM having been estimated to range between 10% to 30% within the first year of life [4], to reduce the risk of postoperative complications (compared to emergency surgery) [9,19], to prevent malignant evolution (risk lower than 1%) [16,20], to encourage compensatory lung growth and also to reduce the need for follow-up imaging studies. Moreover, elective surgery allows thoracoscopic resection, which can provide a shorter hospital stay, decreased post-operative pain and better cosmesis [18,21].…”

Section: Discussionsupporting

confidence: 74%

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Pulmonary Malformations: Predictors of Neonatal Respiratory Distress and Early Surgery

et al. 2016

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Objectives: The objective of our study is to retrospectively analyze a single-centre series of antenatally detected pulmonary malformations (PM) and to evaluate their postnatal outcome. Materials and Methods:We retrospectively reviewed all prenatally diagnosed PM patients referred to our Centre in the period between January 1999 and December 2014. All cases were diagnosed by one of our Maternal-Fetal Specialists by US examination. Congenital pulmonary airway malformation (CPAM) volume ratio (CVR), development of fetal complications, need for fetal therapy, need for neonatal resuscitation and timing of surgery were analyzed.Results: A total of 70 fetuses were diagnosed with a PM in the period of study. An initial CVR higher than 1.6 was found in 16/70 patients (22.8%); 14/16 developed fetal complications (p<.0001). Fifty-six fetuses (80%) did not develop any complications during pregnancy. To all complicated cases a prenatal treatment was offered, carried out in 12 (1 termination, 1 refusal). Survival rate was 100%. Sixty-three fetuses (90%) were asymptomatic at birth and did not require any neonatal resuscitation. Six patients submitted to fetal therapy and one untreated presented with neonatal respiratory distress, required mechanical ventilation at birth and early surgery in the neonatal period (7/70, 10%).Conclusion: CVR > 1.6 and the presence of fetal complications can be considered as predictors of respiratory distress at birth and of the need for early surgery. Nevertheless, the vast majority of PM are asymptomatic at birth and only a small group of fetuses require prenatal and postnatal treatment and support.

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Section: Discussionsupporting

confidence: 74%

“…As many as 15% of CPAM decrease in size during gestation [8] and up to 70-75% prenatally identified pulmonary lesions are asymptomatic at birth [9].…”

Section: Original Articlementioning

confidence: 99%

Pulmonary Malformations: Predictors of Neonatal Respiratory Distress and Early Surgery

et al. 2016

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“…High risk patients are those with large lesions occupying >20 percent of the hemithorax, bilateral or multifocal cysts, or those with pneumothorax. In these patients, surgical resection is preferred to observation (17). On the other hand, in asymptomatic patients without these high-risk characteristics, either elective surgical resection or conservative management with observation are reasonable options (18).…”

Section: Discussionmentioning

confidence: 99%

Intralobar bronchopulmonary sequestration: A case and brief review

Majumdar¹,

Sen²,

Sood³

2018

Southwest J Pulm Crit Care

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Objective: Bronchopulmonary sequestration is a rare congenital abnormality of the lower respiratory tract, seen mostly in children but often in adults. The term implies a mass of lung tissue that has no function and lacks normal communication with the rest of the tracheobronchial tree. Case: A 40-year-old man presented with acute onset of left flank pain for 4 hours. He was born in Yemen and emigrated to the US in 1998; at that time, he had been tested for tuberculosis which was negative. In this admission, he met systemic inflammatory response (SIRS) criteria and had basilar crackles in the left lower lobe of the lung. CT scan revealed a cavitary lesion with air-fluid level in the left lower lobe airspace. There was systemic arterial blood supply to this region arising off the celiac axis. He was diagnosed with an infected intralobar bronchopulmonary sequestration and underwent video-assisted thoracoscopic wedge resection. On follow up 3 months later, he was doing well. Discussion: Pulmonary sequestration is a rare congenital anomaly of a mass of lung tissue, which can have cystic changes and is a very important differential diagnosis of cavities in the lung. Confirmation of diagnosis is by visualization of a systemic vessel supplying sequestrated pulmonary, and this is accomplished by contrast-enhanced CT scan, MRI or invasive angiography. Conclusion:The delay in diagnosis in our patient was due to falling prey to anchoring and availability biases and chasing the diagnosis of tuberculosis in a patient from Yemen with a lower lobe cavitation. Case History of Present Illness:A 40-year-old man with a past medical history of atrial fibrillation presented to the hospital with acute onset of left flank pain for 4 hours, fevers and chills. The pain was sharp and stabbing, pleuritic, non-radiating, and was severe with an intensity of 10/10. He denied extraneous activity or trauma earlier in the day, denied substernal pain, cough, night sweats, weight loss or change in urinary habits. He was born in Yemen and emigrated to the US in 1998; at that time, he was tested for tuberculosis (TB) which was negative. He was known to have a cavitary lesion in left lower lobe since 2005, and had undergone extensive evaluation (imaging, sputum and PPD) which showed no form of tuberculosis. He denied taking prophylactic TB treatment. Annual PPD testing had always been negative.

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“…El tratamiento de lesiones pulmonares asintomáti-cas en la infancia sigue siendo controversial 9 . A favor de las resecciones tempranas está el riesgo de malignidad 10 .…”

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Deformación de la pared torácica como presentación de un blastoma pleuropulmonar, caso clínico

Sáez¹,

Pattillo

Vuletin

2018

Rev. chil. pediatr.

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Recibido el 25 de julio de 2017; aceptado el 18 de noviembre de 2017 Palabras clave: Neoplasia pulmonar; blastoma pleuropulmonar; deformación de la pared torácica ResumenIntroducción: El blastoma pleuropulmonar (BPP) es la neoplasia primaria maligna más común de los pulmones en la infancia. Se presenta con mayor frecuencia en niños entre 1 y 4 años, con sínto-mas respiratorios. Han sido definidos tres tipos por histopatología (tipo I, II y III), relacionados con sobrevida y pronóstico. Objetivo: Reportar el primer caso de un paciente con un BPP que se presentó como una deformación de la pared torácica. Caso clínico: Paciente de un año de vida que se presentó con una deformidad de la pared torácica a los 10 meses de edad. El estudio imagenológico reveló una gran masa quística en el hemitórax derecho. No desarrolló sintomatología respiratoria hasta el ingreso hospitalario. Se realizó una lobectomía superior derecha y la biopsia confirmó un BPP tipo I. Se trató con resección quirúrgica y realización periódica de imágenes torácicas como seguimiento. Conclusiones: Se reporta el caso de un BPP que se manifestó con deformidad torácica, forma de presentación no descrita previamente en la literatura. El BPP es un cáncer poco frecuente que debe ser considerado en el diagnóstico diferencial de lesiones quísticas pulmonares, sobre todo en la edad pediátrica. Reconocerlo como un tumor maligno en vez de una anomalía del desarrollo, es determinante para que el paciente sea sometido a resección quirúrgica, terapia adyuvante y seguimiento apropiado. Keywords:Lung neoplasm; pleuropulmonary blastoma; chest wall deformity Abstract Introduction: Pleuropulmonary blastoma (PPB) is the most common primary malignancy of the lungs in childhood. It occurs more frequently in children between one and four years of age, and respiratory symptoms are a common manifestation. Three types have been defined (type I, II and III), which are related to survival and prognosis. Objective: To report the first case of a patient with a PPB who presented with a chest wall deformity. Case report: One year old male patient who had a chest wall deformity at ten months of age. Imaging revealed a giant cyst in the right hemithorax. He

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Congenital lung lesions: Postnatal management and outcome

Cited by 63 publications

References 63 publications

Pulmonary Malformations: Predictors of Neonatal Respiratory Distress and Early Surgery

Pulmonary Malformations: Predictors of Neonatal Respiratory Distress and Early Surgery

Intralobar bronchopulmonary sequestration: A case and brief review

Deformación de la pared torácica como presentación de un blastoma pleuropulmonar, caso clínico

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