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先天性肺气道畸形的临床与组织病理学谱:病例系列

Clinical and histopathological spectrum of congenital pulmonary airway malformations: A case series.

作者信息

Khan Adil Aziz, Agrawal Meetu, Ahuja Sana

机构信息

Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.

Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.

出版信息

Int J Surg Case Rep. 2024 Sep;122:110096. doi: 10.1016/j.ijscr.2024.110096. Epub 2024 Jul 30.

Abstract

BACKGROUND

Congenital pulmonary airway malformations (CPAM) are a spectrum of cystic and non-cystic anomalies arising from abnormal airway development in utero, with an incidence of 1 in 25,000 to 35,000 births. CPAM can present prenatally or postnatally with respiratory distress, recurrent infections, or occasionally as an incidental finding. This case series aims to highlight the clinical, radiological, and histopathological characteristics of CPAM through three pediatric cases, which include types 1, 2, and 3 CPAM.

CASE PRESENTATION

Case 1: A four-month-old male presented with cough, cold, and respiratory distress. Imaging revealed hypoattenuation and overinflation of the left upper lobe with mediastinal shift. Left upper lobectomy confirmed CPAM type 2. Case 2: A one-month-old female presented with recurrent respiratory distress and infections. Imaging showed a large cystic lesion in the right middle lobe. Right middle lobectomy confirmed CPAM type 3. Case 3: A two-month-old male presented with dyspnea. Imaging showed a large bullae in the right chest with mediastinal shift. Right upper lobectomy confirmed CPAM type 1.

CLINICAL DISCUSSION

CPAM is a rare congenital lung malformation characterized by abnormal bronchial development and localized glandular overgrowth. Management involves surgical resection, with the timing of surgery dependent on symptomatology. Early identification and intervention are crucial for preventing complications such as pulmonary hypoplasia and recurrent infections. Histopathological examination post-resection is essential for accurate classification and management of CPAM.

CONCLUSION

This case series provides valuable insights into the clinical, radiological, and histopathological features of CPAM, including the types encountered in each case. It underscores the importance of early diagnosis and timely surgical intervention, advocating for routine prenatal and postnatal screenings to effectively identify and manage CPAM.

摘要

背景

先天性肺气道畸形(CPAM)是一系列由于子宫内气道发育异常引起的囊性和非囊性异常,在25000至35000例出生中发生率为1例。CPAM可在产前或产后出现呼吸窘迫、反复感染,或偶尔作为偶然发现。本病例系列旨在通过三例儿科病例突出CPAM的临床、放射学和组织病理学特征,其中包括1型、2型和3型CPAM。

病例介绍

病例1:一名4个月大男性出现咳嗽、感冒和呼吸窘迫。影像学显示左上叶低密度和过度充气,伴有纵隔移位。左上叶切除术证实为2型CPAM。病例2:一名1个月大女性出现反复呼吸窘迫和感染。影像学显示右中叶有一个大的囊性病变。右中叶切除术证实为3型CPAM。病例3:一名2个月大男性出现呼吸困难。影像学显示右胸有一个大泡,伴有纵隔移位。右上叶切除术证实为1型CPAM。

临床讨论

CPAM是一种罕见的先天性肺畸形,其特征为支气管发育异常和局部腺体过度生长。治疗包括手术切除,手术时机取决于症状。早期识别和干预对于预防诸如肺发育不全和反复感染等并发症至关重要。切除术后的组织病理学检查对于CPAM的准确分类和管理至关重要。

结论

本病例系列为CPAM的临床、放射学和组织病理学特征提供了有价值的见解,包括每个病例中遇到的类型。它强调了早期诊断和及时手术干预的重要性,提倡进行常规产前和产后筛查以有效识别和管理CPAM。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/28c5/11342210/f9c796429c93/gr1.jpg

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