Person:

Lee, Edward

We report a rare case of 9-month-old girl who presented with a choking episode and was found to have an incidental finding of a lung cyst and iron deficiency anemia leading to the diagnosis of pleuropulmonary blastoma (PPB) and a jejunal hamartoma. Our patient is the eighth that has been reported with the association of PPB with jejunal hamartoma and the first one in the radiological literature. PPB is the pulmonary analog of other dysontogenetic neoplasms in childhood. A biological sequence has been described with the three types of PPB to be interrelated as part of pathologic progression. PPB can be associated with other cysts and/or neoplasms in different organs. PPB is part of a hereditary neoplasia predisposition syndrome in up to 40% of cases. Mutations in DICER gene have been described with PPB. Hence, a pediatric patient diagnosed with PPB should be screened for associated conditions during childhood and adolescence including intestinal polyps. Obtaining family history for other neoplasms or cysts is important information that should raise the possibility of PPB in pediatric patients with cystic lung lesions. The presence of this syndrome should alert the clinician to screen and follow up patients and their relatives.

Lymphatic malformations (LMs) are among the most common pediatric lesions. Due to their rarity, tendency to present later in life than their superficial counterparts, and often incidental identification, intra-abdominal LMs pose a diagnostic dilemma and more prevalent pathologies must be first carefully excluded. Although the diagnosis of the majority of intra-abdominal LMs can be reliably made based on clear understanding of characteristic imaging findings, histologic correlation may be necessary in some cases.

Objective: To provide updates on acute pancreatitis in children regarding imaging, etiologies and complications. Methods: After reviewing current pediatric literature, we discuss the epidemiology, the role of imaging and imaging findings in the diagnosis of acute pancreatitis as well as the etiology and complications. Conclusion: The incidence of acute Pancreatitis is increasing in children. Imaging plays a role in diagnosis, establishing etiology, evaluating complications and possibly in predicting the course.