A missed late presentation of a congenital pulmonary airway malformation as a large infected bulla

Abstract EN

A congenital pulmonary airway malformation (CPAM) is a rare cystic anomaly that may occur during development of the fetal airways.

The vast majority of CPAMs are detected in neonates; as such, it is unusual for diagnosis to occur in adulthood.

We report a 21-year-old male patient who presented to the emergency department of the Hospital Ampang, Kuala Lumpur, Malaysia, in 2015 with chest pain, breathlessness and tachypnoea.

Based on an initial chest X-ray, the patient was misdiagnosed with pneumothorax and underwent urgent chest tube insertion; however, his condition deteriorated over the course of the next three days.

Further imaging was suggestive of infected bullae or an undiagnosed CPAM.

The patient therefore underwent video-assisted thoracoscopic surgery, during which a large infected bulla was resected.

A diagnosis of an infected CPAM was confirmed by histopathological examination.

Following the surgery, the patient recovered quickly and no bullae remnants were found at a one-month follow-up.