bronchial atresia
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Bronchial atresia is a distinct pathological entity that accounts for recurrent pneumonia or respiratory distress in childhood, requiring surgical treatment.
Congenital bronchial atresia (CBA) usually presents incidentally in asymptomatic young male adults but is rarely diagnosed in children. Congenital bronchial atresia presents differently in children than in young adults.
Modern imaging techniques and careful pathological analyses lead to an accurate diagnosis of bronchial atresia, which may be misdiagnosed as intralobar sequestration or pulmonary bronchial cysts.
Pathologic findings include a cystic, blindly terminating, mucus-filled bronchocele without connection to the main bronchial tree, but with normal subsequent generations of bronchi.
Synopsis
round or lobulated perihilar, solid or cystic mass
mucoid impaction
bronchocele (14966358, 8963626)
hyperinflated lung
proximal blind-ending bronchus
pneumothorax (14966358)
Associations
extralobar sequestration (16953677)
intralobar sequestration (16953677)
congenital cystic adenomatoid malformation (16953677)
lobar emphysema (16953677)
Differential diagnosis
intralobar sequestration
pulmonary bronchial cysts
References
Riedlinger WF, Vargas SO, Jennings RW, Estroff JA, Barnewolt CE, Lillehei CW, Wilson JM, Colin AA, Reid LM, Kozakewich HP. Bronchial atresia is common to extralobar sequestration, intralobar sequestration, congenital cystic adenomatoid malformation, and lobar emphysema. Pediatr Dev Pathol. 2006 Sep-Oct;9(5):361-73. PMID: 16953677
Kunisaki SM, Fauza DO, Nemes LP, Barnewolt CE, Estroff JA, Kozakewich HP, Jennings RW. Bronchial atresia: the hidden pathology within a spectrum of prenatally diagnosed lung masses. J Pediatr Surg. 2006 Jan;41(1):61-5; PMID: 16410109
Morikawa N, Kuroda T, Honna T, Kitano Y, Fuchimoto Y, Terawaki K, Kawasaki K, Koinuma G, Matsuoka K, Saeki M. Congenital bronchial atresia in infants and children. J Pediatr Surg. 2005 Dec;40(12):1822-6. PMID: 16338298
Jederlinic PJ, Sicilian LS, Baigelman W, Gaensler EA. Congenital bronchial atresia. A report of 4 cases and a review of the literature. Medicine (Baltimore). 1987 Jan;66(1):73-83. PMID: 3807776