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Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
The patient was a 12 year old female in general good health who developed an upper respiratory infection and had a chest film that demonstrated a right upper lobe cystic mass.
Clinical Physical Exam:
Clinical Differential Diagnosis:
Congenital lobar emphysema, congenital pulmonary airway malformation, pneumatocele
The outside chest film showed a large, cystic lesion in the right upper lobe. Review of a chest film from infancy (not provided) did not demonstrate an obvious lesion. A chest CT exam performed 13 months after diagnosis better defined the mass. A chest film performed 16 months after diagnosis showed the mass was increasing in size.
Images 1 and 2
Images 3 and 4
Imaging Differential Diagnosis:
Congenital pulmonary airway malformation, pneumatocele, bulla
The lesion was found to be slowly enlarging in size and therefore the patient was taken to the operating room 17 months after diagnosis for elective resection. Through a right thoracotomy the mass was seen to arise from the posterior segment of the right upper lobe. It was excised via a posterior segmentectomy.
Examination of the pathological specimen revealed findings characteristic of a congenital pulmonary airway malformation, Type I.
Congenital Pulmonary Airway Malformation, Type I
Follow-up and Prognosis:
The patient had an uncomplicated post-operative course.
Case 19, Case 53
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