title: Prenatal diagnosis of esophageal bronchus--first report of a rare foregut malformation in utero.
abstract: OBJECTIVE
  Esophageal bronchus is a rare bronchopulmonary foregut malformation in which an isolated portion of the respiratory system communicates with the esophagus. There are no reports of prenatal diagnosis of an esophageal bronchus in the literature. We present 5 cases of esophageal bronchus and describe unique imaging findings.
  
  
  METHODS
  Following IRB approval, 5 cases of pathologically proven esophageal bronchus were identified from a single center fetal therapy surgical database. Prenatal magnetic resonance and ultrasound studies were scored for the presence of bronchoceles, cysts, vascular feeders, and location. Five control cases were selected from a radiology database, with lesions determined to represent bronchial atresia prenatally and located at the lung bases. All imaging was reviewed blinded to outcome.
  
  
  RESULTS
  A tubular T2 hyperintense structure (bronchocele) directed from the lung lesion to the gastroesophageal junction was seen in all cases of esophageal bronchus, but in none of the control cases. In all control cases, the bronchocele was directed to the pulmonary hilum. The presence of cysts or vascular feeding vessels was not statistically significant in identifying an esophageal bronchus lesion. All patients were delivered at term and underwent surgical resection between 5 to 19 weeks of age. No postoperative complications occurred.
  
  
  CONCLUSIONS
  Prenatal diagnosis of an esophageal bronchus can be strongly suggested by the presence of a T2 hyperintense structure arising from a lung lesion and directed towards the GE junction. These findings may be helpful for better counseling of parents and improved surgical planning.
authors: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia PA.
authors: Emily A
authors: EA
authors: Partridge
authors: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia PA.
authors: Teresa
authors: T
authors: Victoria
authors: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia PA.
authors: Beverly G
authors: BG
authors: Coleman
authors: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia PA.
authors: Juan
authors: J
authors: Martinez-Poyer
authors: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia PA.
authors: Pablo
authors: P
authors: Laje
authors: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia PA.
authors: Holly L
authors: HL
authors: Hedrick
authors: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia PA.
authors: Alan W
authors: AW
authors: Flake
authors: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia PA. Electronic address: adzick@email.chop.edu.
authors: N Scott
authors: NS
authors: Adzick
mesh_terms: D000328:Adult; D001980:Bronchi / Q000002:abnormalities*; D003937:Diagnosis, Differential; D004947:Esophagus / Q000002:abnormalities*; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D015619:Respiratory System Abnormalities / Q000175:diagnosis* / Q000196:embryology
keywords: Communicating bronchopulmonary foregut malformation; Esophageal bronchus