Congenital pulmonary airway malformation - type I

Case contributed by Dr Praveen Jha

Presentation

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

Patient Data

Age: 1.5
Gender: Female

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.

Multiple cystic areas of varying sizes, reaching upto 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.

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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Case information

rID: 29982
Case created: 9th Jul 2014
Last edited: 14th Mar 2016
System: Chest
Inclusion in quiz mode: Included

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