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  • Imaging Case Report
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A cystic pulmonary lesion in an infant

Journal of Perinatology volume 32, pages 241–242 (2012)Cite this article

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As we were impressed by the spontaneous resolution of these large cystic lesions, the first CT imaging was reinterpreted subsequently. This reinterpretation showed a typical line-and-dot pattern within the air-filled cysts, characteristic for persistent pulmonary interstitial emphysema (PPIE).1 PPIE is a rare condition typically associated with mechanical ventilation of preterm infants, but also seen in term and non-ventilated infants.1, 2 The differential diagnosis of PPIE is broad, including congenital cystic lung lesions, such as congenital cystic adenomatoid malformation, lobar emphysema and bronchogenic cysts.2 CT scan is the diagnostic tool of choice to diagnose PPIE, with a characteristic line-and-dot pattern, attributed to gas in the pulmonary interstitial space surrounding bronchovascular bundles that appear as linear or punctuate soft-tissue densities within the cystic radiolucencies.1 The management of PPIE is either surgical or conservative, depending on the severity of respiratory symptoms. Spontaneous resolution of both localized and diffuse PPIE has been reported.2 This case demonstrates that even large localized PPIE lesions can resolve spontaneously, and that a conservative approach may be appropriate when these lesions are not accompanied by respiratory symptoms.

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References

  1. Donnelly LF, Lucaya J, Ozelame V, Frush DP, Strouse PJ, Summer TE et al. CT findings and temporal course of persistent pulmonary interstitial emphysema in neonates: a multiinstitutional study. Am J Roentgenol 2003; 180: 1129–1133.

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  2. Jassal MS, Benson JE, Mogayzel PJ . Spontaneous resolution of diffuse persistent pulmonary interstitial emphysema. Pediatr Pulmonol 2008; 43: 615–619.

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Authors and Affiliations

  1. Department of Pediatrics, Maastricht University Medical Center, Maastricht, The Netherlands

    M A G E Bannier

  2. Department of Pediatrics, Orbis Medical Center, Sittard, The Netherlands

    P P R Rosias

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  1. M A G E Bannier
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  2. P P R Rosias
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Correspondence to M A G E Bannier.

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Bannier, M., Rosias, P. A cystic pulmonary lesion in an infant. J Perinatol 32, 241–242 (2012). https://doi.org/10.1038/jp.2011.139

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  • DOI: https://doi.org/10.1038/jp.2011.139

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