Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
The patient was a full term newborn male with a prenatal diagnosis of a cystic chest mass, presumed cystic adenomatoid malformation. Immediately after birth he also clinically appeared to have neonatal pneumonia.
Clinical Physical Exam:
Clinical Differential Diagnosis:
Cystic adenomatoid malformation, congenital lobar emphysema.
An AP chest film from the first day of life showed an ill defined cystic mass in the left lower lobe. An unenhanced chest CT exam on the first day of life revealed a left lower lobe heterogenous poly lobulated mass that was cystic and partly fluid filled. An AP chest film taken at 10 months of age again showed the left lower lobe cystic chest mass. A repeat unenhanced chest CT exam done at 10 months of age showed multiple cystic lucent areas in the left lower lobe.
Images 4 and 5
Imaging Differential Diagnosis:
Cystic adenomatoid malformation.
A 11 months of life the child was taken to the operating room for an elective resection of the lesion via a left thoracotomy. The lesion was confined to the upper portion of the left lower lobe. The superior segment of the left lower lobe was removed.
The mass was 9.5 x 4 x 1 cm in size. It consisted of multiple cysts, the largest of which was 2.2 cm in diameter. Most of the cysts were 0.1 - 0.2 cm in diameter.
Cystic Adenomatoid Malformation, Type II
Follow-up and Prognosis:
The patient had an uncomplicated post-operative course.
Case 13, Case 53
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