Right middle lobectomy by thoracoscopic surgery in an adult with congenital cystic adenomatoid malformation (CCAM)

Abstract

The authors report a 42-year-old male who had hemoptysis with an abnormal shadow on chest X-ray films in 1992. He was admitted in 1995 because of a recurrent hemoptysis. Chest X-ray films showed an abnormal cystic shadow in the right middle lung field. Chest CT revealed a cystic shadow with some septal formations. He underwent thoracoscopic surgery with an Endo GIA (autosuture equipment) and double clipping techniques to resect the middle lobe with a diagnosis of CCAM type 1 or intrapulmonary bronchial cyst. Macroscopic examination of the surgical specimen revealed a large cystic lesion with thick walls and septal formation. Microscopic examination showed multiple cysts to be lined by ciliated stratified columnar epithelium and the wall to be composed of elastic tissue without cartilage plates. These findings supported the diagnosis of CCAM type 1. He has been well for 9 months after surgery.