Congenital cystic adenomatoid malformation of lung: Report of two cases with review of literature
A 29-year-old female G4 P3 L2, with history of 24.6 weeks of amenorrhea sought routine antenatal check-up. She gave history of second degree consanguineous marriage. Her third baby girl died 3 days after birth, details of which was not available. Her blood and biochemical investigations were within normal limits. Routine anomalous scan revealed polyhydramnios along with features of congenital diaphragmatic hernia (CDH). The parents were counseled and they opted for termination. Pregnancy was terminated after informed consent and the fetus was sent for pathological evaluation.\nOn autopsy, it was a female fetus. External examination revealed low set ears, short neck, and subcutaneous edema. On internal examination all organs were in situ. The left lung was enlarged (8 × 6 × 4 cm), and cystic in consistency. It was occupying most part of the thorax. Right lung, heart, and thymus were pushed posteriolaterally. Right lung was hypoplastic (3 × 2 × 1 cm). The enlarged left lung was pushing the diaphragm inferiomedially; hence, the spleen was found in umbilical region [Figure -]. Cut-section of the left lung revealed multiple cysts, the larger one was occupying whole of the upper lobe []. On histology, left lung revealed cysts of varying sizes dominated by larger cysts accompanied by smaller cysts. The cysts were lined by flattened cuboidal epithelial cells having fibromuscular septa [Figure -]. Focally, few of the cysts showed mucin production which was evident on Periodic acid-Schiff (PAS) staining [Figure and ]. Cartilage was not seen. All other visceral organs were congested, but well developed and revealed no anomalies. With the above features a pathological diagnosis of CCAM Stocker type I was offered.