VATS for Congenital Lobar Emphysema With Osseous Metaplasia

2018-04-16T18:02:25Z (GMT) by Saleh Abu Daff
<p></p> <p>This video demonstrates a video-assisted thoracoscopic resection of a congenital lobar emphysema in a young woman with spontaneous pneumothorax. Congenital lobar emphysema occurs when there is a developmental ball-valve obstruction in the bronchial tree. This is usually related to bronchial malformation and most commonly affects the left upper lobe.</p><p>Small osseous formations were observed in the resected lobe. Pulmonary osseous metaplasia (OM) is a poorly understood phenomenon related to chronic inflammation and possibly related to fibroblast transformation triggered by TGF-β. Most cases of pulmonary OM are reported in conjunction with usual interstitial pneumonia, but it has also been described to a lesser extent in other lung conditions. A diffuse (dendriform) bilateral form of the disease has also been described.<br></p><p><b>Suggested Reading</b></p><p></p><ol><li>Schwartz MZ, Ramachandran P. Congenital malformations of the lung and mediastinum--a quarter century of experience from a single institution. <em><a href="https://www.ncbi.nlm.nih.gov/pubmed/9021566">J Pediatr Surg. 1997;32(1):44-47</a></em>.</li><li>Poon C. Pulmonary Osseous Metaplasia Associated With UI. <em><a href="https://doi.org/10.1378/chest.1119658">Chest. 2011;140(4)(suppl):134A</a></em>.</li><li>Hashemi N, Gill N, Balasubramanian V. Bony Metaplasia in Interstitial Lung Disease. <em><a href="https://doi.org/10.1378/chest.1118122">Chest. 2011;140(4)(suppl):119A</a></em>.</li><li>Konoglou M, Zarogoulidis P, Baliaka A, et al. Lung ossification: an orphan disease. <em><a href="https://doi.org/10.3978/j.issn.2072-1439.2013.01.09">J Thorac Dis. 2013;5(1):101-104</a></em>.</li></ol><p>The case was submitted as a poster for the Gulf Thoracic 2017 Meeting in Dubai.</p><p></p>