Congenital pulmonary airway malformation - type I

Case contributed by Praveen Jha
Diagnosis almost certain

Presentation

Recurrent pneumonia, breathlessness. Previous chest radiograph showed possible diaphragmatic hernia.

Patient Data

Age: 1.5 years
Gender: Female

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

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Large cystic areas in right hemithorax with some of them showing air-fluid levels, with contralateral mediastinal shift. Diaphragmatic outline is not well visualized on right side. Possibility of diaphragmatic hernia was being considered.

This study is a stack
Axial lung
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This study is a stack
Axial liver
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Multiple cystic areas of varying sizes, reaching up to 8 cm in size are seen replacing most of the lung parenchyma. Residual lung parenchyma appears compressed and atelectatic. Contralateral tracheomediastinal shift is seen. Diaphragmatic continuity appears intact.

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A post-contrast radiograph taken, also shows above mentioned findings.

Case Discussion

Congenital pulmonary airway malformation type I, has large cystic areas, which may have air-fluid levels. Also, these large cysts may produce mass effect and mediastinal shift, which may be confused with congenital diaphragmatic hernia on a radiograph. Cross-sectional imaging helps in this regard.

(Case courtesy: Dr. Abhijit Yadav, Dr. B L Yadav center for diagnostic imaging and research).

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