title: Bronchial atresia: the hidden pathology within a spectrum of prenatally diagnosed lung masses.
abstract: OBJECTIVE
  This study was aimed at determining whether different congenital lung masses represent diverse manifestations of a single developmental abnormality associated with fetal airway obstruction.
  
  
  METHODS
  We conducted a 3-year retrospective review of patients who underwent surgical resection of a prenatally diagnosed lung mass. Prenatal imaging was used to define mass position and its effect on adjacent organs. Lung specimens were examined through careful full-specimen microdissections, as well as by plain and contrast roentgenograms.
  
  
  RESULTS
  Twenty-five patients underwent lung resection during this study period. Based on the final pathology reports, 56% were congenital cystic adenomatoid malformations, 12% were congenital lobar emphysemas, 8% were bronchopulmonary sequestrations, and 24% had features of both cystic adenomatoid malformation and bronchopulmonary sequestrations. No bronchogenic cysts were present in this series. Overall, bronchial atresia was identified in 77% of the examined specimens (n = 22) and was associated with all types of lung malformations.
  
  
  CONCLUSIONS
  Bronchial atresia is a common, unrecognized component of prenatally diagnosed congenital cystic adenomatoid malformations, bronchopulmonary sequestrations, congenital lobar emphysemas, and lesions of mixed pathology. Most congenital lung masses may be part of a spectrum of anomalies linked to obstruction of the developing fetal airway as an underlying component in their pathogenesis.
authors.affiliation: Department of Surgery, Children's Hospital Boston and Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Shaun M
authors.initials: SM
authors.lastname: Kunisaki
authors.forename: Dario O
authors.initials: DO
authors.lastname: Fauza
authors.forename: Luanne P
authors.initials: LP
authors.lastname: Nemes
authors.forename: Carol E
authors.initials: CE
authors.lastname: Barnewolt
authors.forename: Judy A
authors.initials: JA
authors.lastname: Estroff
authors.forename: Harry P
authors.initials: HP
authors.lastname: Kozakewich
authors.forename: Russell W
authors.initials: RW
authors.lastname: Jennings
mesh_terms: D000402:Airway Obstruction / Q000209:etiology; D005315:Fetal Diseases / Q000209:etiology* / Q000473:pathology*; D006801:Humans; D007231:Infant, Newborn; D008171:Lung Diseases / Q000150:complications*; D011296:Prenatal Diagnosis; D018633:Pulmonary Atresia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology*; D013902:Radiography, Thoracic; D012189:Retrospective Studies