General Lung Lesions

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[size=20px]A 15 month-old boy presents with a cough. A chest x-ray and subsequent CT scan demonstrate a cystic mass in the right lower lobe. Two prenatal ultrasounds showed no evidence of a lung lesion. The most appropriate management is:​ A Bronchoscopy B Repeat chest x-ray in three months C Right lower lobectomy D Thoracoscopic wedge resection of cyst E Cyst aspiration and sclerosis​[/size]

[size=20px]A 3 month-old term infant was diagnosed prenatally with a congenital lung lesion. She had no respiratory issues postnatally and remains well. She recently underwent a CT scan of the chest and is in your clinic to review the results. Which features on history and imaging are associated with an increased risk of malignancy? A Size less than 3 cm B Macrocystic lung lesion C Prenatal detection D Presence of a systemic feeding vessel E All of the above​[/size]

[size=20px]A 5-month-old girl is being seen in your clinic for a right lower lobe cystic lung mass. She had a CXR performed for a chronic cough and the lesion was seen. Chest CT scan was performed and shows a macrocystic 4 cm lesion in the right lower lobe, with question of a feeding vessel. Her mother had serial prenatal ultrasounds for placental position and the lesion had not been seen. In this child’s history, which factor is most concerning for possible malignancy? A Absence of lesion on prenatal ultrasound B Location of lesion C Presence of systemic feeding vessel D Size of lesion[/size]

[size=20px]A previously healthy six month male infant presents with cough and fever. A chest radiograph reveals bronchiolitic changes and a large right lung cyst. After treatment, a follow up CXR 6 weeks later is normal except for a persistent cyst, and chest CT scan demonstrates a multilocular, 5 cm peripheral lung cyst in the right lower lobe, without air fluid levels or a feeding vessel. Prenatal ultrasounds were normal. The next step in the care of this child should be: A Bronchoscopy B Sweat test to exclude cystic fibrosis C Thoracoscopic or open right lower lobectomy D B-Catenin gene analysis E Repeat CXR in 3 months[/size]