A pathological analysis of pediatric pulmonary cystic/cavitary lesions

Pediatric pulmonary cystic/cavitary lesions are uncommon. The spectrum of cystic/cavitary pulmonary lesions in pediatric patients includes congenital and acquired lesions. They have similar clinical presentation and overlapping radiologic features. Histopathology plays an important role in diagnosis. This study was planned to describe the spectrum of surgically resected cystic/cavitary pulmonary lesions in pediatric patients (age <12 years) and correlate clinical features with pathology findings. This is a single-center 10-year retrospective descriptive study. The cases were divided into two categories: congenital and acquired. Demographic details, clinical presentation, and investigational data were correlated with pathology findings.The study included 40 cases of surgically resected cystic/cavitary pulmonary lesions received from pediatric patients. Congenital lesions (22 cases, 55%) predominated over acquired lesions (18 cases, 45%). Cystic pulmonary airway malformation (29.2%, 12 cases) was the most common lesion and the most common cystic lesion overall. Acquired lesions included hydatid cyst (nine cases) and post infectious (post abscess) cavitary lesions (nine cases which included two cases of tuberculosis). Most congenital lesions were found in the neonates and infants and none found in late childhood, while most acquired lesions belonged to late childhood with no case found in neonates. Though radiology plays an important role in the diagnosis of cystic/cavitary lesions, histopathology is the key investigation for confirmation. Very few studies that describe the clinico-pathologic spectrum of these rare lesions in children were found in the literature.