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, cystic adenomatoid 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:
Cystic adenomatoid 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 cystic adenomatoid malformation, Type I.
Cystic Adenomatoid Malformation, Type I
Follow-up and Prognosis:
The patient had an uncomplicated post-operative course.
Case 19, Case 53
Follow us on Twitter @pedseducation and @pedsimaging
Please send us comments by filling out our Comment Form.
All contents copyright © 1992-2016 Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. and the authors. All rights reserved.
"Virtual Pediatric Hospital", the Virtual Pediatric Hospital logo, and "A digital library of pediatric information" are all Trademarks of Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D.
Virtual Pediatric Hospital is funded in whole by Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. Advertising is not accepted.
Your personal information remains confidential and is not sold, leased, or given to any third party be they reliable or not.
The information contained in Virtual Pediatric Hospital is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.