• Journal of Chest Surgery
• /
• v.28 no.2
• /
• pp.193-195
• /
• 1995

Congenital lobar emphysema is an uncommon disease affecting newborns and infants with respiratory distress. This report describes a 1.9kg premature baby of 31weeks gestation who developed respiratory distress symptoms of congenital lobar emphysema involved left upper lobe.Left upper lobe lobectomy was carried out and good result was obtained. So, we present one case report with literature review.

• Journal of Chest Surgery
• /
• v.32 no.1
• /
• pp.62-65
• /
• 1999

Infantile lobar emphysema is an uncommon disease affecting newborns and infants with varying degree of respiratory distress, lobar overaeration, mediastinal shift and herniation. Although the etiology of the condition is most commonly idiopathic, there is a clear association with congenital heart disease, particularly in the presence of pulmonary hypertension due to left to right shunt. Sites of predilection are the left main bronchus, the left upper and right middle bronchi. This report describes a two-week-old boy who had right middle lobe emphysema with large ventricular septal defect. At first, patch closure of perimembranous ventricular septal defect was performed. Postoperatively, the patient required continuing assisted ventilation and the lobar emphysema was not improve. One week following the initial operation, right middle lobectomy was successfully performed and the patient was weaned from artificial ventilator on the 5th postoperative day. The patient was discharged with good general condition on the 45th postoperative day.

• Journal of Chest Surgery
• /
• v.27 no.10
• /
• pp.882-884
• /
• 1994

Congenital lobar emphysema is one of the abnormal development of pulmonary parenchyme which may cause respiratory distress in infant. This disease is an unusual condition barely mentioned before 1949, and only 166 cases were reported till 1967 in English literature. This report describes a 13 months old girl who had a congenital left upper lobar emphysema. The left upper lobectomy was the operation for this case and the postoperative course was not eventful, and have been in good condition upto now.

• Journal of Chest Surgery
• /
• v.25 no.12
• /
• pp.1428-1431
• /
• 1992

In a 14-days-old boy chest roentgenogram examination because of dyspnea and cyanosis revealed hyperlucency of entire right lung field with herniation of mediastinum into the left hemithorax, Surgical exploration showed the right lower lobe to be site of congenital lobar emphysema, while the right upper and middle lobe were collapsed. Right lower lobectomy was successfully performed.

• Journal of Chest Surgery
• /
• v.41 no.3
• /
• pp.335-342
• /
• 2008

Background: Congenital cystic diseases of the lung are uncommon, and they share similar embryogenic and clinical characteristics. But they are sometimes vary widely in their presentation and severity. Therefore they are often difficult to make different diagnosis each other, and all require surgical treatment. Material and Method: From 1993 to 2006, 38 patients underwent surgical procedures under these diagnostic categories in the Depart. of Thoracic and. Cardiovascular Surgery, Busan-Paik Hospital, College of Medicine, Inje University. And we retrospectively reviewed these patients' charts for clinical presentations, surgical procedures, pathologic findings and postoperative morbidity and mortality. Result: There were 22 males and 16 females, ages ranged from 1 month after birth to 51 years and mean age was 20.8 years. The main symptoms were 19 fever, cough, sputum production due to recurrent infection, 7 dyspnea, 8 chest discomfort, 4 hemoptysis, but eight patients were asymptomatic. Computed tomography was chosen as diagnostic modalities and available for operation plan for all of patients. For all the cases, surgical resection were performed. Lobectomy was performed in 28 patients, simple excision (resection) in 8 patients, segmentectomy or wedge resection in 2 patients. There were 10 pulmonary sequestrations, 15 congenital cystic adenomatoid malformations (CCAM), 11 bronchogenic cysts, and 2 congenital lobar emphysemas. They all were confirmed by pathologic exams. The complications were 6 wound disruption or infection, 2 chylothorax, 1 ulnar neuropathy, but all of them were resolved uneventful. There was no persistent air leakage, respiratory failure, operative mortality and recurrence. Conclusion: We performed immediate surgical removal of congenital cystic lung lesions after diagnosis and obtained good results, so reported them with literature review.

• Tuberculosis and Respiratory Diseases
• /
• v.65 no.2
• /
• pp.110-115
• /
• 2008

Background: Congenital cystic adenomatoid malformation of the lung (CCAM) is a rare congenital developmental anomaly of the lower respiratory tract. Most cases are diagnosed within the first 2 years of life, so adult presentation of CCAM is rare. We describe here six adult cases of CCAM and the patients underwent surgical resection, and all these patients were seen during a five and a half year period. The purpose of this study was to analyze the clinical, radiological and histological characteristics of adult patients with CCAM. Methods: Through medical records analysis, we retrospectively reviewed the clinical characteristics, the chest pictures (X-ray and CT) and the histological characteristics. Results: Four patients were women and the mean age at diagnosis was 23.5 years (range: 18~39 years). The major clinical presentations were lower respiratory tract infection, hemoptysis and pneumothorax. According to the chest CT scan, 5 patients had multiseptated cystic lesions with air fluid levels and one patient had multiple cavitary lesions with air fluid levels, and these lesions were surrounded by poorly defined opacities at the right upper lobe. All the patients were treated with surgical resection. 5 patients underwent open lobectomy and one patient underwent VATS lobectomy. On the pathological examination, 3 were found to be CCAM type I and 3 patients were CCAM type II, according to Stocker's classification. There was no associated malignancy on the histological studies of the surgical specimens. Conclusion: As CCAM can cause various respiratory complications and malignant changes, and the risks associated with surgery are extremely low, those patients who are suspected of having or who are diagnosed with CCAM should go through surgical treatment for making the correct diagnosis and administering appropriate treatment.

• Tuberculosis and Respiratory Diseases
• /
• v.46 no.1
• /
• pp.129-135
• /
• 1999

We describe unusual manifestations of congenital cystic adenomatoid malformation (C.C.A.M.) of the lung, such as movable fungal ball-like intracystic blood clots and hemoptysis, which were detected in previously healthy 23 years-old woman. We identified blood clots only after left upper lobectomy and could not distinguish from fungal ball with radiographic methods. CCAM of the lung, rare and lethal form of congenital pulmonary cystic disease, was initially introduced by Ch, in and Tang in 1949. The histogenesis of this lesion is characterized by polypoid glandular tissue proliferation and overgrowth of mesenchymal elements due to cessation of bronchiolar maturation which occurred in after 16weeks intrauterine period. In 80-95% of reported cases, the lesion was confined to a single lobe and there was no lobe and right and left lung predilection The clinical presentation may be widely variable, ranging from intrauterine fetal death to late discovery in childhood with recurrent pulmonary infection. But there,s no reports which were misdiagnosed with intracystic fungal ball. The treatment choice is lobectomy of affected lobe. There,s a few case reports with rhabdomyosarcoma, bronchiolar cell carcinoma and myxosarcoma arising in CCAM patients. Therefore, early resection is recommended even if asymtomatic cases. We experienced a rare case of CCAM of the lung in 23 years old female, and there were intracystic fungal ball-like movable blood clots in lower portion of left lung. After left upper lobectomy was performed, now she is discharged and followed up without any complications.