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Pediatric Radiology

, Volume 47, Issue 13, pp 1766–1775 | Cite as

Neonatal congenital lung tumors — the importance of mid-second-trimester ultrasound as a diagnostic clue

  • Stephan L. Waelti
  • Laurent GarelEmail author
  • Dorothée Dal Soglio
  • Françoise Rypens
  • Michael Messerli
  • Josée Dubois
Original Article

Abstract

Background

The differential diagnosis for primary lung masses in neonates includes a variety of developmental abnormalities; it also consists of the much rarer congenital primary lung tumors: cystic pleuropulmonary blastoma (cystic PPB), fetal lung interstitial tumor (FLIT), congenital peribronchial myofibroblastic tumor (CPMT), and congenital fibrosarcoma. Radiologic differentiation between malformations and tumors is often very challenging.

Objective

The objective was to establish distinctive features between developmental pulmonary abnormalities and primary lung tumors.

Materials and methods

We conducted a retrospective study of 135 congenital lung lesions at a university mother and child center over a period of 10 years (2005–2015). During this time, we noted four tumors (two cystic PPBs and two FLITs) and 131 malformations. We recorded the following parameters: timing of conspicuity in utero (mid-second trimester, third trimester, or not seen prenatally), presence of symptoms at birth, prenatal and perinatal radiologic findings, and either histological diagnoses by pathology or follow-up imaging in non-operated cases.

Results

All lesions except the four tumors were detected during mid-second-trimester ultrasound. In none of the tumors was any pulmonary abnormality found on the mid-second-trimester sonogram, contrary to the developmental pulmonary abnormalities.

Conclusion

The timing of conspicuity in utero appears to be a key feature for the differentiation between malformations and tumors. Lesions that were not visible at the mid-second-trimester ultrasound should be considered as tumor. A cystic lung lesion in the context of a normal mid-second-trimester ultrasound is highly suggestive of a cystic PPB. Differentiating the types of solid congenital lung tumors based upon imaging features is not yet feasible.

Keywords

Computed tomography Fetus Lungs Malformations Neonates Radiography Tumors Ultrasound 

Notes

Acknowledgments

The results of this study were presented at the International Pediatric Radiology Conjoint Meeting and Exhibition 2016 in Chicago, IL.

Compliance with ethical standards

Conflicts of interest

None.

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Stephan L. Waelti
    • 1
  • Laurent Garel
    • 1
    Email author
  • Dorothée Dal Soglio
    • 2
  • Françoise Rypens
    • 1
  • Michael Messerli
    • 3
  • Josée Dubois
    • 1
  1. 1.Department of Medical Imaging, Sainte-Justine HospitalUniversity of MontrealQuebecCanada
  2. 2.Department of Pathology, Sainte-Justine HospitalUniversity of MontrealQuebecCanada
  3. 3.Department of Nuclear MedicineUniversity Hospital Zurich, University of ZurichZurichSwitzerland

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