Education  |   August 2017
Images in Anesthesiology: Congenital Pulmonary Airway Malformation
Author Notes
  • From the Department of Anesthesia (R.S., M.M.) and Department of Radiology (K.L., R.F.), Cincinnati Children’s Hospital, Cincinnati, Ohio.
  • Address correspondence to Dr. Subramanyam: Rajeev.Subramanyam@cchmc.org
Article Information
Education / Images in Anesthesiology / Airway Management / Pediatric Anesthesia / Respiratory System / Technology / Equipment / Monitoring
Education   |   August 2017
Images in Anesthesiology: Congenital Pulmonary Airway Malformation
Anesthesiology 8 2017, Vol.127, 382. doi:10.1097/ALN.0000000000001602
Anesthesiology 8 2017, Vol.127, 382. doi:10.1097/ALN.0000000000001602
A 2-MONTH-OLD girl presented with a congenital pulmonary airway malformation (CPAM) as demonstrated by computed tomography angiography (figs. A and B).
CPAM is a rare developmental abnormality of the lower respiratory tract with an incidence of 1:7,200 to 1:27,400.1  CPAMs are composed of cystic and adenomatous elements, which arise from tracheal, bronchial, bronchiolar, or alveolar tissue. These lesions do not participate in gas exchange and can compromise alveolar growth and development. Large lesions can cause mediastinal shift, cardiac and caval compression with resultant polyhydramnios, and hydrops fetalis. Hydrops carries a high mortality rate, and fetal intervention may be indicated. Although usually sporadic, CPAMs are associated with cardiac, renal, and gastrointestinal anomalies.2  There is a small risk of malignant transformation. Hence, early detection and surgery are important.
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