title: Congenital cystic lesions of the lungs: The perils of misdiagnosis - A single-center experience.
abstract: BACKGROUND
  A majority of cystic lesions in the western world are detected antenatally, whereas, the diagnosis in our setup occurs once the child becomes symptomatic. Surgical management is primarily dictated by the presence of symptoms, recurrent infection, and rarely by the potential risk of malignant transformation.
  
  
  METHODS
  A retrospective analysis was carried out on all consecutive patients with cystic lung lesions managed at our center from January 2000 through June 2011 for antenatal diagnosis, presentation, diagnostic modalities, treatment, and complications.
  
  
  RESULTS
  Forty cystic lung lesions were identified. Only 8% were antenatally detected. Out of 40, the final diagnosis was congenital cystic adenomatoid malformation in 19, congenital lobar emphysema in 11, and bronchogenic cysts and pulmonary sequestration in five each. Of these, 20% had received a course of prior antitubercular therapy and 30% had an intercostal drain inserted prior to referral to our center. Postoperative morbidity in the form of bronchopleural fistula, pneumothorax, and non-expansion of the residual lung was noted in 10% of the patients.
  
  
  CONCLUSIONS
  Antenatal diagnosis of these lesions is still uncommon in third world countries. Prior to referral to a pediatric surgical center a large number of patients received antitubercular drugs and an intercostal drain insertion, due to incorrect diagnosis.
authors: Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.
authors: V Shankar
authors: VS
authors: Raman
authors: Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.
authors: Sandeep
authors: S
authors: Agarwala
authors: Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.
authors: Veereshwar
authors: V
authors: Bhatnagar
authors: Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.
authors: Shasanka Shekhar
authors: SS
authors: Panda
authors: Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.
authors: Arun Kumar
authors: AK
authors: Gupta
keywords: Antenatal diagnosis; antitubercular drugs; congenial cystic lung lesions; intercostal drainage