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[Pediatric lung lesions: a clinicopathological study of 215 cases]
Huilin Niu1, Fenghua Wang, Wei Liu
1Department of Pathology, Guangzhou Women and Children's Medical Center, Guangzhou 510623, China;
Insights
Lung abscesses are the most frequent lung lesions in children, followed by congenital pulmonary airway malformations. Infectious diseases dominate pediatric lung conditions, with congenital bronchopulmonary dysplasia prevalent in infants under one year.
Area of Science:
- Pediatric Pulmonology
- Thoracic Pathology
- Pediatric Radiology
Background:
- Lung lesions in children present a diverse range of pathologies.
- Understanding the spectrum of pediatric lung diseases is crucial for accurate diagnosis and management.
Purpose of the Study:
- To investigate the clinical and pathological features of lung lesions in a pediatric cohort.
- To identify the most common types of lung diseases affecting children.
Main Methods:
- Retrospective analysis of 215 pediatric lung lesion cases.
- Inclusion of clinical, radiological, histopathological, and immunohistochemical data.
- Age stratification to compare disease incidence in different pediatric age groups.
Main Results:
- Lung abscesses were the most common diagnosis (40.0%), followed by congenital pulmonary airway malformation (CPAM) (20.5%) and pulmonary sequestration (11.6%).
- Congenital lung diseases were more frequent in infants under one year compared to older children (P = 0.004).
- Infectious diseases constituted the majority of acquired lung diseases, while neoplastic lesions were rare (6.0%).
Conclusions:
- Infectious diseases are the leading cause of lung lesions in children.
- Congenital bronchopulmonary dysplasia is significantly more common in infants (<1 year).
- Malignant lung lesions are infrequent in the pediatric population.
Objective:
To investigate clinical and pathological features of lung lesions in children.
Methods:
Clinical manifestations, radiologic imaging, histopathological features and immunohistochemical results were analyzed in 215 cases of lung lesions in children.
Results:
A total of 215 cases of lung lesions in children aged 0 day to 13 years (average age of 27.2 months and the median age of 18.0 months) were selected, including 137 male and 78 female patients with a male to female ratio of 1.76:1.00. The incidence of congenital lung disease was higher in patients of less than 1 year old than those of over 1 year old age, and the difference of the two groups was statistically significant (P = 0.004). 142 cases had acquired lung diseases, and 73 cases had congenital bronchopulmonary dysplasia. Lung abscess was the most common lesion seen in 86 cases (40.0%), including 1 case of fungal abscess. Congenital pulmonary airway malformation (CPAM) was the second most common, seen in 44 patients (20.5%), including 20 cases of type 1, 18 cases of type 2 and 6 cases of type 4 CPAM. Pulmonary sequestration was found in 25 cases (11.6%) including 14 cases of intralobar type and 11 cases of extralobar type. Two cases of extralobar pulmonary sequestration showed simultaneous CPAM2 type 2 lesion. Other lesions included tuberculosis (13 cases, 6.0%), emphysema (12 cases, 5.6%), interstitial pneumonia (7 cases, 3.2%), pulmonary hemorrhage (6 cases, 2.8%), bronchogenic cyst (4 cases, 1.9%), bronchiolitis obliterans (2 cases, 0.9%), idiopathic pulmonary hemosiderin deposition disease (2 cases, 0.9%) and 1 cases of lung non-specific changes. 13 cases of neoplastic lesions (6.0%) were found, of which 11 cases were primary tumors (5.1%), including inflammatory myofibroblastic tumor in 5 patients (2.3%), pleuropulmonary blastoma in 5 cases (1 case of type I, 2 type II and 2 type III) and 1 case of mucoepidermoid carcinoma (0.5%) and 2 cases of metastatic tumors (hepatoblastoma and Wilm's tumor, 0.9%).
Conclusions:
Infectious diseases are the most common lung diseases in children. Congenital bronchopulmonary dysplasia is the most common in children of less than 1 year old. Malignant lesions are rare.
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