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2011-06-07-16 Cystic adenomatoid malformation of the lung © Cuillier www.TheFetus.net


Cystic adenomatoid malformation of the lung 


Fabrice Cuillier, MD.

Department of Gynecology, Félix Guyon Hospital, 97400 Saint-Denis, Ile de la Réunion, France.


Case report

This is a case of a 30-year-old woman G5P4, with an unremarkable personal and family history. Her ultrasound scan at 13 weeks was normal (nuchal translucency = 1 mm, CRL= 60 mm) and triple test was negative. 

The patient was referred to our department at 21 weeks of gestation. Our ultrasound exam revealed an intrathoracic lung lesion of solid appearance on the left. Our differential diagnosis included a congenital cystic adenomatoid malformation of the lung. There were no signs of lung sequestration (no aberrant artery). There was a dextroposition of the heart but the cardiac anatomy seemed normal. There were no other associated abnormalities and there was a normal amount of the amniotic fluid.

During the end of the second trimester and during the third trimester, we observed a regression of the left lung lesion. At 31 weeks, the heart was on the left and the left lung had a normal echogenicity.

The patient delivered vaginally at 39 weeks of gestation.The postnatal adaptation of the neonate was without any complications. The clinical examination and chest X-ray revealed normal results.

Our final diagnosis was a congenital cystic adenomatoid malformation of the lung with a spontaneous regression.

Images 1,2: 21 weeks, transverse views of the left lung showing cystic and solid component of the lung lesion.

 

 

Images 5,6: Image 5, 21 weeks, lung lesion 40 x 26 mm, the heart is pushed to the right. Image 6, 23 weeks, left lung lesion and dextroposition of the heart.

 

Images 7,8
: 23 weeks, Image 7 shows a 4-chamber view of the heart and cystic lung lesion 19 x 19 mm. Image 8 shows the color Doppler of the heart showing the filling of both ventricles.

 

Images 9,10: 26 weeks, transverse and sagittal view of the left lung.

 

Images 11,12: 28 weeks, left lung lesion with a cystic component measuring 21 x 42 mm. 31 weeks, the heart is on the left and the left lung has a normal appearance and echogenicity.

 


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