Bronchial atresia: The hidden pathology within a spectrum of prenatally diagnosed lung masses

Shaun M. Kunisaki, Dario O. Fauza, Luanne P. Nemes, Carol E. Barnewolt, Judy A. Estroff, Harry P. Kozakewich, Russell W. Jennings

Research output: Contribution to journalArticle

Abstract

Purpose: This study was aimed at determining whether different congenital lung masses represent diverse manifestations of a single developmental abnormality associated with fetal airway obstruction. Methods: We conducted a 3-year retrospective review of patients who underwent surgical resection of a prenatally diagnosed lung mass. Prenatal imaging was used to define mass position and its effect on adjacent organs. Lung specimens were examined through careful full-specimen microdissections, as well as by plain and contrast roentgenograms. Results: Twenty-five patients underwent lung resection during this study period. Based on the final pathology reports, 56% were congenital cystic adenomatoid malformations, 12% were congenital lobar emphysemas, 8% were bronchopulmonary sequestrations, and 24% had features of both cystic adenomatoid malformation and bronchopulmonary sequestrations. No bronchogenic cysts were present in this series. Overall, bronchial atresia was identified in 77% of the examined specimens (n = 22) and was associated with all types of lung malformations. Conclusions: Bronchial atresia is a common, unrecognized component of prenatally diagnosed congenital cystic adenomatoid malformations, bronchopulmonary sequestrations, congenital lobar emphysemas, and lesions of mixed pathology. Most congenital lung masses may be part of a spectrum of anomalies linked to obstruction of the developing fetal airway as an underlying component in their pathogenesis.

Original languageEnglish (US)
Pages (from-to)61-65
Number of pages5
JournalJournal of pediatric surgery
Volume41
Issue number1
DOIs
StatePublished - Jan 2006
Externally publishedYes

Keywords

  • Bronchial atresia
  • Bronchopulmonary sequestration
  • Congenital cystic adenomatoid malformation
  • Congenital lobar emphysema
  • Congenital lung malformation
  • Congenital lung mass
  • Fetus
  • Lung development
  • Prenatal diagnosis

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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  • Cite this

    Kunisaki, S. M., Fauza, D. O., Nemes, L. P., Barnewolt, C. E., Estroff, J. A., Kozakewich, H. P., & Jennings, R. W. (2006). Bronchial atresia: The hidden pathology within a spectrum of prenatally diagnosed lung masses. Journal of pediatric surgery, 41(1), 61-65. https://doi.org/10.1016/j.jpedsurg.2005.10.082