A case of aspergillosis of the lung, against the background of congenital cystic adenomatous malformation
CLINICAL CASE
Abstract
Cysticadenomatousmalformationisacongenitalmalformationof thelungsthatresultsfromabnormalitiesin themorphogenesisoflungbranchingatdifferentstagesofdevelopment,andindifferentareasof thetracheobronchealtree,withtheformationofcysts.Cysticadenomatousmalformationaccountsfor25%ofcongenitallungmalformations.Inmostcases, theanomalyisdetectedduringthenewbornperiodorinthefirstyearoflife.Aspergillosisisasapronousmycosiswithanaspirationmechanismoftransmissionof thepathogen,characterizedby apredominantlesionof thelungs.Persistentcavitiesinthelungsofvariousoriginsarea“favorite”place(predisposingfactor)for thedevelopmentofaspergillosis.ThearticlepresentstheexperienceofsuccessfultreatmentofpatientK.,24yearsold,withpulmonaryaspergillosis,onthebackgroundofcysticadenomatousmalformation.Thepatientunderwentathoracoscopiclowerlobectomyon theright.Thelowerlobeof therightlung,whichcontainedcysticcavitieswithpurulentcontents, wasremoved. Apathomorphologicalexaminationof theremovedmaterialconfirmedthediagnosisofcysticadenomatousmalformationof thelowerlobeof therightlungandrevealedacultureof theAspergillumfungus.
References
1. Lakhoo K., Mngongo C. Congenital cystic lung lesion. In: E.A. Ameh, S.W. Bickler, K. Lakhoo et al. Paediatric surgery: a comprehensive text for Africa. Seattle, WA, USA: Global Help Organization; 2011:287–291.
2. Wilson R.D., Hedrick H.L., Liechty K.W., Flake A.W., Johnson M.P., Bebbington M., Adzick N.S. Cystic adenomatoid malformation of the lung: review of genetics, prenatal diagnosis, and in utero treatment. Am J Med Genet A. 2006;140(2):151–5.
3. Mehta P.A., Sharma G. Congenital Pulmonary Airway Malformation. Treasure Island (FL): Stat Pearls Publishing; 2025.
4. Шестак Е.В. Кистозно-аденоматозная мальфармация легкого II типа у новорожденного. Проблемы ранней диагностики. Уральский медицинский журнал. 2022;21(1):77–84. https://doi.org/10.52420/2071-5943-2022-21-1-77-84.
5. Тащилкина Ю.В., Тащилкин А.И., Кузьминых С.В., Александров Т.А., Поздняков А.В., Подкаменев А.В. Врожденная кистозно-аденоматозная мальформация легкого III типа (клинический случай). Визуализация в медицине. 2023;5(2):32–37.
6. Aryal K., Regmi P.R., Adhikari G., Bhhattarai U., Sedhain S.P. Congenital pulmonary airway malformation (CPAM): A case report and review of the literature. Radiol Case Rep. 2023;18(10):3483–3486. https://doi.org/10.1016/j.radcr.2023.07.018.
7. Denning D.W., Cadranel J., Beigelman-Aubry C. et al. Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management. Eur Respir J. 2016;47(1):45–68. https://doi.org/10.1183/ 13993003.00583-2015.
8. Николаева Н.Г., Шадривова О.В., Ицкович И.Э., Климко Н.Н. Хронический аспергиллез легких: обзор литературы и демонстрация собственных наблюдений. Вестник рентгенологии и радиологии. 2021;102(5):317–328. https://doi.org/10.20862/0042-4676-2021-102-5-317-328.
9. Lamoth F., Calandra T. Pulmonary aspergillosis: diagnosis and treatment. Eur Respir Rev. ;31(166):220114. https://doi.org/10.1183/16000617.0114-2022.
10. Page I.D., Byanyima R., Hosmane S. et al. Chronic pulmonary aspergillosis commonly complicates treated pulmonary tuberculosis with residual cavitation. Eur Respir J. 2019;53(3):1801184. https://doi.org/10.1183/ 13993003.01184-2018.
11. Lowes D., Al-Shair K., Newton P.J. et al. Predictors of mortality in chronic pulmonary aspergillosis. Eur Respir J. 2017;49(2):1601062. https://doi.org/10.1183/ 13993003.01062-2016.
12. Stocker J.T., Madewell J.E., Drake R.M. Congenital cystic adenomatoid malformation of the lung. Classification and morphologic spectrum. Hum Pathol. 1977;8(2):155–71. https://doi.org/10.1016/s0046-8177(77)80078-6.
13. Stocker J.T. Congenital pulmonary airway malformation: a new name and an expanded classification of congenital cystic adenomatoid malformation of the lung. Histopathology. 2002;41:424–431.
14. Benouaich V., Marcheix B., Begueret H., Brouchet L., Velly J.F., Jougon J. Malignancy of congenital cystic adenomatoid malformation of lung in aged. Asian Cardiovasc Thorac Ann. 2009;17:634–636.
15. Feng A., Cai H., Sun Q. et al. Congenital cystic adenomatoid malformation of lung in adults: 2 rare cases report and review of the literature. Diagn Pathol. 2012;7:37. https://doi.org/10.1186/1746-1596-7-37.
16. Yonker L.M., Mark E.J., Canapari C.A. Aspergilloma in a patient with an occult congenital pulmonary airway malformation. Pediatr Pulmonol. 2011. https://doi.org/10.1002/ppul.21538.
