Mid-trimester resolution of marked dextroposition of the fetal heart preceding regression of extensive left fetal lung lesion consisting of hybrid congenital pulmonary airway malformation (CPAM) and bronchopulmonary sequestration (BPS)
Extensive congenital pulmonary airway malformation (CPAM) of the left fetal lung and associated marked dextroposition of the fetal heart were noted at 21 weeks’ gestation. The right fetal lung appeared compressed with the cardiomediastinal shift angle measuring approximately 20 degrees. Potential su...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-03-01
|
| Series: | Radiology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1930043324013451 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832595799829118976 |
|---|---|
| author | David M. Sherer, MD Ida Dhanuka, MD Kayla Schacher, MD Hubert Rodriguez-Tejada, MD Aleksandra Zigalo, RDMS Mila Kheyman, RDMS Harry Zinn, MD Fancisca T. Velcek, MD Mudar Dalloul, MD |
| author_facet | David M. Sherer, MD Ida Dhanuka, MD Kayla Schacher, MD Hubert Rodriguez-Tejada, MD Aleksandra Zigalo, RDMS Mila Kheyman, RDMS Harry Zinn, MD Fancisca T. Velcek, MD Mudar Dalloul, MD |
| author_sort | David M. Sherer, MD |
| collection | DOAJ |
| description | Extensive congenital pulmonary airway malformation (CPAM) of the left fetal lung and associated marked dextroposition of the fetal heart were noted at 21 weeks’ gestation. The right fetal lung appeared compressed with the cardiomediastinal shift angle measuring approximately 20 degrees. Potential subsequent right pulmonary hypoplasia was considered. At 26 weeks’ gestation, despite the continued presence of extensive CPAM of the left fetal lung, spontaneous resolution of the dextroposition of the fetal heart was noted. Subsequent repeat ultrasound assessments confirmed gradual continued in-utero regression of the left lung lesion. The patient spontaneously delivered a vigorous infant neonate at 39 and 4/7 weeks’ gestation. Birth weight was 3175 grams, and following brief CPAP management for mild transient tachypnea of the newborn, and negative chest X-ray, the infant was discharged in good health on Day 2 of life. Neonatal CT angiography demonstrated CPAM of the left lower lobe. In addition, a feeding vessel was seen emanating directly from the thoracic aorta, indicating an intralobar brochopulmonary sequestration (BPS) component of the left lung lesion, consistent with a hybrid lung lesion (CPAM and intralobar BPS). At 2 months of life the infant underwent uneventful resection of the left lower lobe with pathology confirmation of the hybrid lung lesion. This case demonstrates that relatively rapid regression of severe cardiomediastinal shift associated with extensive hybrid lung lesions may occur. Our case indicates that spontaneous regression of marked cardiomediastinal shift appears to be a reassuring prognostic sign despite the continued presence of this lesion. |
| format | Article |
| id | doaj-art-ca6642e49c6741859cc0bdad58fd04b9 |
| institution | Kabale University |
| issn | 1930-0433 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj-art-ca6642e49c6741859cc0bdad58fd04b92025-01-18T05:04:00ZengElsevierRadiology Case Reports1930-04332025-03-0120316751680Mid-trimester resolution of marked dextroposition of the fetal heart preceding regression of extensive left fetal lung lesion consisting of hybrid congenital pulmonary airway malformation (CPAM) and bronchopulmonary sequestration (BPS)David M. Sherer, MD0Ida Dhanuka, MD1Kayla Schacher, MD2Hubert Rodriguez-Tejada, MD3Aleksandra Zigalo, RDMS4Mila Kheyman, RDMS5Harry Zinn, MD6Fancisca T. Velcek, MD7Mudar Dalloul, MD8Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY, USA; Corresponding author.Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY, USADivision of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY, USADivision of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY, USADivision of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY, USADivision of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY, USADepartment of Radiology, State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY, USADivision of Pediatric Surgery, Department of Surgery, State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY, USADivision of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY, USAExtensive congenital pulmonary airway malformation (CPAM) of the left fetal lung and associated marked dextroposition of the fetal heart were noted at 21 weeks’ gestation. The right fetal lung appeared compressed with the cardiomediastinal shift angle measuring approximately 20 degrees. Potential subsequent right pulmonary hypoplasia was considered. At 26 weeks’ gestation, despite the continued presence of extensive CPAM of the left fetal lung, spontaneous resolution of the dextroposition of the fetal heart was noted. Subsequent repeat ultrasound assessments confirmed gradual continued in-utero regression of the left lung lesion. The patient spontaneously delivered a vigorous infant neonate at 39 and 4/7 weeks’ gestation. Birth weight was 3175 grams, and following brief CPAP management for mild transient tachypnea of the newborn, and negative chest X-ray, the infant was discharged in good health on Day 2 of life. Neonatal CT angiography demonstrated CPAM of the left lower lobe. In addition, a feeding vessel was seen emanating directly from the thoracic aorta, indicating an intralobar brochopulmonary sequestration (BPS) component of the left lung lesion, consistent with a hybrid lung lesion (CPAM and intralobar BPS). At 2 months of life the infant underwent uneventful resection of the left lower lobe with pathology confirmation of the hybrid lung lesion. This case demonstrates that relatively rapid regression of severe cardiomediastinal shift associated with extensive hybrid lung lesions may occur. Our case indicates that spontaneous regression of marked cardiomediastinal shift appears to be a reassuring prognostic sign despite the continued presence of this lesion.http://www.sciencedirect.com/science/article/pii/S1930043324013451Prenatal ultrasoundCongenital pulmonary airway malformation (CPAM)Bronchopulmonary sequestration (BPS)Hybrid lung lesionDextroposition of the fetal heartCardiomediastinal shift angle |
| spellingShingle | David M. Sherer, MD Ida Dhanuka, MD Kayla Schacher, MD Hubert Rodriguez-Tejada, MD Aleksandra Zigalo, RDMS Mila Kheyman, RDMS Harry Zinn, MD Fancisca T. Velcek, MD Mudar Dalloul, MD Mid-trimester resolution of marked dextroposition of the fetal heart preceding regression of extensive left fetal lung lesion consisting of hybrid congenital pulmonary airway malformation (CPAM) and bronchopulmonary sequestration (BPS) Radiology Case Reports Prenatal ultrasound Congenital pulmonary airway malformation (CPAM) Bronchopulmonary sequestration (BPS) Hybrid lung lesion Dextroposition of the fetal heart Cardiomediastinal shift angle |
| title | Mid-trimester resolution of marked dextroposition of the fetal heart preceding regression of extensive left fetal lung lesion consisting of hybrid congenital pulmonary airway malformation (CPAM) and bronchopulmonary sequestration (BPS) |
| title_full | Mid-trimester resolution of marked dextroposition of the fetal heart preceding regression of extensive left fetal lung lesion consisting of hybrid congenital pulmonary airway malformation (CPAM) and bronchopulmonary sequestration (BPS) |
| title_fullStr | Mid-trimester resolution of marked dextroposition of the fetal heart preceding regression of extensive left fetal lung lesion consisting of hybrid congenital pulmonary airway malformation (CPAM) and bronchopulmonary sequestration (BPS) |
| title_full_unstemmed | Mid-trimester resolution of marked dextroposition of the fetal heart preceding regression of extensive left fetal lung lesion consisting of hybrid congenital pulmonary airway malformation (CPAM) and bronchopulmonary sequestration (BPS) |
| title_short | Mid-trimester resolution of marked dextroposition of the fetal heart preceding regression of extensive left fetal lung lesion consisting of hybrid congenital pulmonary airway malformation (CPAM) and bronchopulmonary sequestration (BPS) |
| title_sort | mid trimester resolution of marked dextroposition of the fetal heart preceding regression of extensive left fetal lung lesion consisting of hybrid congenital pulmonary airway malformation cpam and bronchopulmonary sequestration bps |
| topic | Prenatal ultrasound Congenital pulmonary airway malformation (CPAM) Bronchopulmonary sequestration (BPS) Hybrid lung lesion Dextroposition of the fetal heart Cardiomediastinal shift angle |
| url | http://www.sciencedirect.com/science/article/pii/S1930043324013451 |
| work_keys_str_mv | AT davidmsherermd midtrimesterresolutionofmarkeddextropositionofthefetalheartprecedingregressionofextensiveleftfetallunglesionconsistingofhybridcongenitalpulmonaryairwaymalformationcpamandbronchopulmonarysequestrationbps AT idadhanukamd midtrimesterresolutionofmarkeddextropositionofthefetalheartprecedingregressionofextensiveleftfetallunglesionconsistingofhybridcongenitalpulmonaryairwaymalformationcpamandbronchopulmonarysequestrationbps AT kaylaschachermd midtrimesterresolutionofmarkeddextropositionofthefetalheartprecedingregressionofextensiveleftfetallunglesionconsistingofhybridcongenitalpulmonaryairwaymalformationcpamandbronchopulmonarysequestrationbps AT hubertrodrigueztejadamd midtrimesterresolutionofmarkeddextropositionofthefetalheartprecedingregressionofextensiveleftfetallunglesionconsistingofhybridcongenitalpulmonaryairwaymalformationcpamandbronchopulmonarysequestrationbps AT aleksandrazigalordms midtrimesterresolutionofmarkeddextropositionofthefetalheartprecedingregressionofextensiveleftfetallunglesionconsistingofhybridcongenitalpulmonaryairwaymalformationcpamandbronchopulmonarysequestrationbps AT milakheymanrdms midtrimesterresolutionofmarkeddextropositionofthefetalheartprecedingregressionofextensiveleftfetallunglesionconsistingofhybridcongenitalpulmonaryairwaymalformationcpamandbronchopulmonarysequestrationbps AT harryzinnmd midtrimesterresolutionofmarkeddextropositionofthefetalheartprecedingregressionofextensiveleftfetallunglesionconsistingofhybridcongenitalpulmonaryairwaymalformationcpamandbronchopulmonarysequestrationbps AT fanciscatvelcekmd midtrimesterresolutionofmarkeddextropositionofthefetalheartprecedingregressionofextensiveleftfetallunglesionconsistingofhybridcongenitalpulmonaryairwaymalformationcpamandbronchopulmonarysequestrationbps AT mudardalloulmd midtrimesterresolutionofmarkeddextropositionofthefetalheartprecedingregressionofextensiveleftfetallunglesionconsistingofhybridcongenitalpulmonaryairwaymalformationcpamandbronchopulmonarysequestrationbps |