Imaging description

A chest radiograph (Fig. 21.1a) was obtained on an asymptomatic newborn infant because of a history of a right lower lobe abnormality discovered in utero. The newborn chest radiograph showed only subtle increased markings at the right lung base (Fig. 21.1a). Prenatal imaging had included ultrasound (US) and MRI at 29 weeks (Fig. 21.1b). Both studies had shown a large somewhat heterogeneous complex lesion, mostly solid with some cystic components, occupying most of the right lung posteriorly and with some midline mass effect (Fig. 21.1b). There was also a linear low signal branching structure noted inferiorly suggesting a systemic vascular supply to the lesion from below the diaphragm (Fig. 21.1b). The findings were consistent with a bronchopulmonary malformation (BPM), with hybrid feature of pulmonary sequestration (systemic arterial supply) and cystic pulmonary airway malformation (CPAM) (cysts). Serial ultrasound studies demonstrated moderate progressive decrease in the size of the lesion in the third trimester of pregnancy.