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Congenital pulmonary airway malformation (CPAM) and bronchogenic cysts are developmental anomalies of the respiratory system that occur during embryogenesis. CPAM involves abnormal proliferation of terminal respiratory structures creating cystic masses, while bronchogenic cysts arise from abnormal budding of the primitive foregut during tracheobronchial tree development.
CPAM results from arrested development of pulmonary mesenchyme with abnormal communication between bronchioles and alveolar structures, leading to adenomatoid proliferation and cyst formation. Bronchogenic cysts develop when portions of the developing respiratory tract become sequestered during the pseudoglandular stage of lung development, typically between the 6th-16th weeks of gestation, resulting in fluid-filled cystic structures lined with respiratory epithelium.
Both conditions can present with respiratory distress in neonates or remain asymptomatic until adulthood when complications arise such as infection, pneumothorax, or malignant transformation. Imaging studies including chest X-ray, CT, and MRI help differentiate between the two conditions, with CPAM showing multiple cysts of varying sizes and bronchogenic cysts appearing as solitary, well-defined masses. Surgical resection is the definitive treatment, with timing dependent on symptom severity and risk of complications.