2024 Friday Quiz 45 Answer | Figure 1

CincyKidsRad

Cincinnati Children's Radiology

2024 Friday Quiz 45 Answer

Coronal contrast-enhanced CT of the chest shows a soft tissue mass (arrow) in the lower right lung. Pleuropulmonary blastoma is the most common primary pulmonary malignancy in the pediatric population. It is classified into types I (cystic), II (cystic and solid), and III (solid). Type I tumors are more common in younger children and have a more favorable prognosis while Type III tumors appear in older children and carry a poorer prognosis. All variants are linked to DICER1 syndrome.

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Axial (image 1) and coronal (image 2) CT shows a mixed cystic and solid suprasellar mass (arrows). Axial T2 (image 3), FLAIR (image 4), and T1 postcontrast (image 5) highlight the cystic and solid nature of the mass as well as its predominantly suprasellar location. Aadamantinomatous craniopharyngiomas have a lobulated contour caused by multiple cystic lesions. While solid components are often present, they represent only a small portion of the mass. Calcifications are common. Papillary craniopharyngiomas are the second type of craniopharyngioma.

Axial contrast enhanced CT shows a large solid mass of the chest. Pleuropulmonary blastoma is the most common pulmonary malignancy of childhood. The masses can have a variable appearance from cystic air-filled masses to completely solid masses. The solid masses present later in childhood and have a worse prognosis. #ThoraxThursday

Axial (image 1) and sagittal (image 2) CT of the chest shows a multicystic lesion (arrow) within the left lower lobe and surrounding hyperinflated lung (arrowhead) consistent with a congenital pulmonary airway malformation (CPAM). A CPAM is an abnormal mass of pulmonary tissue with varying cystic change that communicates with the tracheobronchial tree and has normal blood supply and drainage. The lesions can be classified radiographically based on the size and number of cysts. A dominant large cyst (type I) is most common. Other types include a small cyst lesion (type II) or a microcystic lesion (type III) which has a solid appearance.

AP (image 1) and lateral (image 2) chest radiograph and coronal (image 3) and axial (image 4) T2 weighted fetal MRI show a multiloculated cystic mass (arrow) in the left lower lobe consistent with a congenital pulmonary airway malformation (CPAM). CPAMs are classified based on cyst size. Type I lesions are the most common and typically have a single large dominant cyst. Type II lesions have multiple small cysts while type III lesions appear solid due to microcysts. The lesions are resected.