CONGENITAL lung malformations detection has increased substantially over the past three decades, with a marked rise in congenital pulmonary airway malformation diagnoses and frequent inflammatory findings identified in surgically treated cases.
Changing Patterns in Congenital Lung Malformations
A nationwide retrospective study examined all patients diagnosed with congenital lung malformations between 1986–2015 to assess epidemiology, treatment patterns, outcomes, and mortality. Researchers reviewed histological findings, treatments, and primary outcomes, while mortality associated with congenital lung malformations was analysed using official death certificates.
The data demonstrated a significant increase in the detection of congenital lung malformations during the study period. Detection rates rose from 1.9 per 100,000 live births in 1990 to 23.1 per 100,000 live births in 2015 (p<0.0001). This increase was driven by a rise in the detection of congenital pulmonary airway malformation, while rates of other congenital lung malformations remained stable.
The findings also revealed a notable shift in the pattern of diagnosed lesions over time. Conditions such as sequestration and bronchogenic cysts became proportionally less prominent as congenital pulmonary airway malformation diagnoses increased.
Surgical Management and Histological Findings
Surgery was the predominant treatment approach in the cohort. A total of 257 patients, representing 77% of the study population, underwent operative management.
Histological examination was available for resected lesions and identified inflammation in 53 specimens, accounting for 37.6% of those assessed. Importantly, no malignancies were detected in any histological sample reviewed during the study period.
The presence of inflammatory changes in resected lesions was observed even though congenital lung malformations may be asymptomatic. These findings may have implications for clinical decision making when considering management strategies.
Mortality Outcomes and Clinical Implications
Mortality related to congenital lung malformations was uncommon but remained evident. One adult death occurred in a previously undiagnosed individual. Additional mortality included four stillborn infants and eight neonatal deaths in cases where surgery was not performed. Two neonatal deaths occurred despite attempted surgical intervention.
Researchers also evaluated the safety of operative management across age groups. The complication rate associated with surgery did not differ significantly between adults and children.
Overall, the study highlights a substantial increase in the detection of congenital lung malformations over a 30-year period and documents changing patterns of disease presentation. The frequent identification of inflammation in surgical specimens may support consideration of surgical management, even in the absence of clinical symptoms.
Reference
Nuutinen S et al. Thirty-year nationwide research on epidemiology, treatment, and outcomes of congenital lung malformations. Sci Rep. 2026; https://doi.org/10.1038/s41598-026-55729-w.
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