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The vast majority of prenatally diagnosed congenital pulmonary malformations (CPM) remain asymptomatic at birth. The maximal value of the CPM volume ratio (CVRmax) predicts the risk of neonatal respiratory distress (NRD), and should allow for better assessment of the level of expertise needed at the delivery site. This study evaluated the level of maternity units currently chosen for the delivery of CPMs, and determined the impact of the choice of delivery site based on the CVRmax, with a threshold of 0.4 cm2. Data were extracted from the French prospective MALFPULM cohort, with inclusion between March 2015 and June 2018. The final study population consisted of 383 women. Deliveries in level 1 or 2 maternity units (n = 98, 25%) involved CPMs with lower CVRmax (p <0.001), causing fewer signs of prenatal compression (p = 0.025). Among the 62 children (16%) who presented with NRD, only seven (11%) were born in level 1 or 2 units (p = 0.0078). Choosing the maternity level according to the CVRmax would have increased the number of births in level 1 or 2 maternity hospitals by 70%. In these maternity units, the percentage of children with NRD would have increased from 8% in the actual distribution to 10% in the new strategy. Our results showed an overuse of level 3 maternity hospitals for the delivery of newborns with a prenatal diagnosis of CPM. The use of CVRmax should enable a reduction in the use of expertise centers without an adverse impact on newborns. [ABSTRACT FROM AUTHOR]

Introduction: Congenital cystic adenomatoid malformation (CCAM), especially type-III, shares similar sonographic features with congenital lobar emphysema (CLE) in routine ultrasound scan. Thus, prenatal differentiation of CLE from a microcystic CCAM is challenging and difficult in practice. Discovery of molecular biomarkers has important clinical significance.Methods: We profiled gene expression in lung tissue from four CCAM type-III and five CLE subjects by microarray. A bioinformatic tool was used for signal pathways enrichment analysis. Further, quantitative reverse transcriptase PCR (qRT-PCR) was used to verify the results.Results: A total of 426 genes were identified to be significantly differentially expressed (fold-change >2.0, q value <0.05) between microcystic CCAM and CLE. Of these differentially expressed genes (DEGs), 392 were upregulated and 34 were downregulated in microcystic CCAM compared with CLE. Unsupervised clustering of the "expressed" genes could clearly delineate the CCAM and CLE samples. We also confirmed that eight randomly chose genes were differentially expressed at the mRNA level between CCAM and CLE.Conclusions: CCAM type-III and CLE have differential gene expression patterns. Our pilot study may gain a deeper understanding of the organogenetic origins and pathogenesis of these conditions. The suggestive candidates may serve as potential biomarkers for definitive diagnosis of congenital cystic lung lesions and eventually to treat them appropriately. [ABSTRACT FROM AUTHOR]

Traumatic Pulmonary Pseudocysts (TPPs) are a rare consequence of thoracic trauma that is seen disproportionately in young adults and paediatric populations. In this case report, we detail a case of a TPP initially misdiagnosed on imaging as a Congenital Cystic Adenomatoid Malformation (CCAM). Conservative management and monitoring for resolution of TPP is highly effective as in most cases it self-resolves without issue or need for intervention. This contrasts with the surgical treatment often indicated for symptomatic CCAMs. Clearly, failure to recognize TPP as a rare but important differential of pulmonary cystic lesions in the context of trauma can lead to significant distress for the patient's family, over investigation and unnecessary or harmful interventions. We also review in this article the literature surrounding the radiological appearances, clinical features and management of both conditions. [ABSTRACT FROM AUTHOR]

The article describes the processes of collecting and adapting the diagnostic information necessary for use in automated analysis of three-dimensional images and surgical navigation. The work is carried out on the basis of the NMRC Obstetrics, Gynecology And Perinatology named after V.I. Kulakov of the Ministry of Health of the Russian Federation with the financial support of the Ministry of Science and Education of the Russian Federation (Agreement dated 03.10.2016 No. 14.607.21.0162, unique identifier RFMEFI60716X0162) The work is devoted to the features of collection, segmentation and description of the results of preoperative radiological diagnostics of newborn patients with congenital malformations of the lungs, such as bronchopulmonary sequestration (BS) and congenital cystic adenomatous malformation (CCAM). The goal of the work is the development of standards for the collection, classification and segmentation of various diagnostic information of congenital lung malformations in newborns necessary to use in automated three-dimensional image analysis and surgical navigation. In order to expand the scope of application, it was decided to supplement the data bank with information from the patient’s phenotypic chart, compiled by the clinical geneticist when examining the patient. According to the developed and implemented algorithms we collected and segmented 924 series of images belonging to 148 patients with lung anomalies and 356 series of normal lung. Available text descriptions of the series are reconstructed to the original developed standard. At present, using this data bank, a subsystem of neural network analysis and reconstruction of diagnostic images of newborn patients is being developed, as well as a surgical navigation system for performing endoscopic surgical manipulations on patients for congenital malformations of the lungs. [ABSTRACT FROM AUTHOR]

Purpose Congenital cystic adenomatoid malformation (CCAM) of the lung in adults is very rare. We aimed to evaluate the clinicoradiological features of adult patients with CCAM. Methods Adult patients diagnosed with CCAM were evaluated for clinicoradiological presentation and management. Methods Nine patients were diagnosed with CCAM (four were incidentally diagnosed on chest imaging). Most cases appeared on computed tomography as thin-walled multiseptated cystic lesions. Two patients had another concurrent pulmonary developmental anomaly. Five patients were surgically treated and three conservatively. Conclusions CCAMs might be incidentally diagnosed on routine chest imaging in adults and can be safely treated with minimally invasive techniques. [ABSTRACT FROM AUTHOR]