Clinical Features Of Congenital Cystic Adenomatoid Malformation In Children

ObjectiveCongenital cystic adenomatoid malformation is a congenital lung airway abnormality.The incidence rate is between 1:25 000 and 1:35 000 in the developed population.Most of the children are asymptomatic,and may have clinical manifestations such as cough,sputum,fever,and even difficulty breathing due to oppression and secondary infection,and have no specificity.And imaging is not easy to distinguish from other diseases,especially bronchogenic cysts and pulmonary sequestration,and is easily missed and misdiagnosed.Therefore,we reviewed the clinical manifestations,imaging findings,pathological findings,diagnosis and prognosis of patients with congenital cystic adenomatoid malformations from January 2012 to December 2017.In the same period,clinical data of children with bronchogenic cysts and pulmonary sequestration were compared,it can help clinicians better understand these diseasesMethodsFrom January 2012 to December 2017,56 cases of congenital cystic adenomatoid malfommation diagnosed by pathology,49 cases of pulmonary sequestration and 26 cases of bronchogenic cysts were collected.Statistical analysis was performed on these three types of diseases from clinical manifestations,imaging examinations,pathological results,diagnosis and treatment,etc.,to understand these diseases in children.Results1.Among the 56 children with congenital cystic adenomatoid malformations,22(39.29%)were found as a result of respiratory infection,another 31(55.36%)were detected by prenatal ultrasonography and medical examination.Pathology showed that 23 cases were type ? congenital cystic adenomatoid malformations(41.07%),33 cases were type ? congenital cystic adenomatoid malformations(58.93%)without differences between different gender,location or symptom.However,there was a significant difference in age distribution between symptomatic and asymptomatic children.2.Of the 49 children with pulmonary sequestration,18(36.73%)were found as a result of respiratory infections,28(55.36%)were found by prenatal ultrasound.There was no significant difference in gender between the symptomatic and asymptomatic children(?2=2.163,P=0.14137),but there was a difference in age distribution(D=0.4810,P=0.005).3.Of the 26 children with bronchogenic cysts,13(50.00%)were found for respiratory infections.4 were found due to neck lumps,5 were found by prenatal ultrasound,and 3 were accidentally discovered by chest imaging examination.All patients underwent surgery.Statistical analysis showed that there was no significant difference in gender distribution between the symptomatic and asymptomatic children(?2=0.462,P=0.497).Conclusion1.In this study,there were 56 patients with CCAM included 23 patients with type ? and 33 patients with type ?.Type ? and type ? CCAM were not significantly ditterent between different gender,location or symptom.2.There were no significant differences in the symptoms of respiratory tract infection between CCAM,bronchogenic cysts and pulmonary sequestration.But there were significant differences in the distribution of gender distribution and asymptomatic proportion.3.The use of prenatal ultrasound and postnatal imaging studies contributes to the early diagnosis and differential diagnosis of CCAM.