Congenital pulmonary airway malformation mimicking lung cancer: A case report

Abstract

Rationale: Congenital pulmonary airway malformation (CPAM) is a rare developmental deformity of the lower respiratory tract. The disease occurs more in newborns. However, on rare occasions, CPAM can be found in adults. Radiologic features of CPAM include cystic or solid mass pattern. In an elderly patient, CPAM can be easily misdiagnosed as lung cancer.

Patient concerns: A 66-year old woman was admitted with complaints of chronic cough, expectoration. Her past history was unremarkable with no history of tuberculosis or smoking. Physical examination was normal. Computerized tomography of the chest showed an irregular cystic lesion in right lower lobe.

Diagnosis: Histopathological results confirmed the diagnosis of CPAM.

Intervention: The right pulmonary wedge resection was performed via thoracoscopic surgery.

Outcomes: On follow up 1 year later, the patient is asymptomatic.

Lessons: CPAM is rare in adults, and imaging cannot accurately distinguish CPAM from thin-walled cystic lung cancer. Hence, histopathology is mandatory to confirm the diagnosis.

Figure 1

(A–C) Chest radiography showed a 35 × 22 mm cystic lesion in the right lower lung. Lung window setting (A), soft tissue window setting (B), and contrast enhanced chest CT (C). CT = computerized tomography.

Figure 2

Histopathology (H&E, ×40), lesion composed of varying sized cysts, lined by pseudostratified ciliated columnar epithelium. The wall of the cysts contains smooth muscle, blood vessels, and cartilage. Relatively normal alveoli may be seen interspersed between the cyst.