Congenital cystic lung lesions: a clinical analysis of 28 newborns

Objective: To discuss the clinical features of congenital cystic lung lesions (CCLL) in newborns. Method: From January 2008 to June 2014, 28 newborns treated at Department of Neonatology, Guangzhou Women and Children’s Medical Center for CCLL, were retrospectively analyzed. The baseline information, clinical manifestations, imaging findings, diagnosis, treatment and prognosis were analyzed with literature review. Results: There were 20 males and 8 females with CCLL. By the type of lesions, there were 16 cases (57.14%) with congenital lobar emphysema, 7 cases (25.00%) with pulmonary sequestration, 4 cases (14.29%) with congenital cystic adenomatoid malformation, and 1 case (3.75%) with bronchogenic cyst. Clinical manifestations included shortness of breath (78.57%), cyanosis (39.29%), cough and gasp (17.86%), feeding intolerance (14.29%), and fever (10.71%); asymptomatic cases accounted for 21.43%. Two cases were combined with congenital heart disease and four were combined with other deformities (diaphragmatocele, laryngeal cartilage dysplasia, funnel chest and polycystic kidney disease). Chest CT revealed lesions in all cases. Four cases received pulmonary lobectomy, and 2 of these 4 cases received emergency surgeries, while the remaining cases received conservative treatment. Among all 28 cases, 17 cases were improved and discharged from hospital; 8 cases were discharged against medical advice, and 3 cases died. Conclusion: Congenital lobar emphysema is the most common type of CCLL in newborns, mainly presented as shortness of breath and cyanosis. The suspected cases of CCLL should receive chest CT or MRI as early as possible. Doppler echocardiography and other ultrasonic examinations should be performed as well to exclude deformities. Good outcomes usually occur for CCLL patients and long-term follow-up is necessary.