Testing & Diagnosis for Cystic Lung Disease in Children

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How is cystic lung disease diagnosed?

If your child's physician suspects a cystic lung disease, the following tests may be performed:

  • prenatal ultrasound
  • chest computerized tomography scan of the lungs (CT or CAT scan)-- this is a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images of your child’s lungs.
  • Chest x-ray. This is a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones and organs of the chest onto film.

The four conditions of cystic lung disease may become symptomatic, or be discovered, at different times:

Bronchogenic cysts

The condition is usually discovered on a fetal ultrasound or a chest x-ray after your fetus or newborn demonstrates signs and symptoms of airway obstruction.

CCAM

  • A CCAM may be a coincidental finding at fetal ultrasound or it may be diagnosed when an ultrasound is done on a fetus in distress.
  • Whether cystic or solid, a CCAM can be life threatening to the fetus, leading to a mediastinal shift, impaired function of the heart and fetal hydrops (congenital heart failure). Therefore, if your child’s doctors detect a lesion prenatally, they will want to monitor it closely.

Lobar emphysema

  • This condition is usually also discovered on a chest x-ray after your child demonstrates extreme difficulty and pain with breathing.
  • These symptoms usually become apparent right after birth, but may be delayed for as long as five to six months in some patients. Other patients remain undiagnosed until school age or beyond.
  • If the obstruction is not found on an x-ray, a bronchoscope may be used. For this procedure, the bronchoscope, a lighted tube, is passed down your child’s windpipe so that doctors can examine the bronchial tubes.

Pulmonary sequestration

  • Extralobar sequestration is most often found coincidentally when your baby is a newborn because of the discovery of another anomaly, such as a diaphragmatic hernia.
  • In contrast, intralobar sequestration is typically discovered when your child is somewhat older, and has a lobar pneumonia that does not clear up or that leaves a radiographic abnormality even after the infection has been successfully treated.
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