Developmental bronchopulmonary disease in adults: practical clinical considerations

Developmental abnormalities of the tracheobronchial tree and its vascular components may be seen in both pediatric and adult patients. These abnormalities occur as pure bronchial anomalies (in which the vascular organization is normal), as pure vascular anomalies (in which the bronchial arborization has proceeded normally) or as combined bronchial and vascular anomalies. The clinical syndromes associated with these anomalies may usefully be considered together as different aspects of potential failure of bronchovascular development. In the adult the bronchogenic cyst is the most commonly encountered pure bronchial abnormality, arteriovenous malformation the commonest pure vascular anomaly and sequestration the most frequent mixed defect. Between 1958 and 1978, 32 bronchogenic cysts, 14 sequestrations and 18 parenchymal aneurysms were treated at the Toronto General Hospital. Diagnostic and therapeutic considerations suggest that surgical intervention is warranted in most cases.