Presentation
Routine antenatal ultrasound at 19 weeks of gestation.
Patient Data
Ultrasound shows presence of a well defined wedge shaped echogenic lesion in right lower lung.
Case Discussion
Main differentials of echogenic fetal pulmonary masses include pulmonary sequestration and cystic pulmonary airway malformation (CPAM) type III.
These may be differentiated on the basis of presence a separate feeding vessel usually arising from aorta in cases of sequestration.
Type III cystic pulmonary airway malformation consists of small cysts less than 0.5 cm and appears grossly solid on ultrasound. Usually there is no systemic feeding vessel, however, CPAM may occur in concert with sequestration (i.e. a hybrid lesion) 1.