Lili Wang1,2, Fumin Zhao3, Hanmin Liu4,5,6, Lina Chen7,8. 1. Division of Pediatric Pulmonology and Immunology, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China. 2. Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, 610041, Sichuan, China. 3. Radiology Department, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China. 4. Division of Pediatric Pulmonology and Immunology, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China. hanmin@vip.163.com. 5. Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, 610041, Sichuan, China. hanmin@vip.163.com. 6. NHC Key Laboratory of Chronobiology, Sichuan University, Chengdu, 610041, Sichuan, China. hanmin@vip.163.com. 7. Division of Pediatric Pulmonology and Immunology, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China. chenlina_78@163.com. 8. Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, 610041, Sichuan, China. chenlina_78@163.com.
Abstract
An azygos lobe is a rare anatomic variant of the lung which may be misdiagnosed as other pathological conditions. There is a dearth of information on the clinical characteristics of children with azygos lobe. This study aims to summarize the clinical features of children with azygos lobe, which may be helpful to improve recognition and clinical care of those patients. Clinical findings of the children with imaging findings of azygos lobe were collected and analyzed. In this study, 50 children with azygos lobe were included. A total of 28% cases were found to have azygos lobe incidentally. The remaining 72% cases were diagnosed when they presented with respiratory symptoms including cough (36%), fever (34%), wheezing (18%), dyspnea (14%), and cyanosis (8%). Congenital heart disease, Down syndrome, and other respiratory malformations were also found in a small proportion of these patients. Only 7 (14%) patients suffered from azygos lobe infection and were clinically cured after reasonable anti-infective treatment. Compared with the non-infected group, no valuable risk factors were found to be related to azygos lobe infection. All children who had azygos lobe infections responded to appropriate antibiotics therapy. There was no evidence that an azygos lobe was associated with recurrent infections. Conclusion: The clinical characteristics of children with azygos lobe are nonspecific and diagnosis relies on chest imaging. Some congenital abnormalities may be complicated with azygos lobe. It is reasonable to keep watch over those patients without symptoms. What is Known: • An azygos lobe is a congenital variation of the lung. • Azygos lobe can mimic various pathological conditions leading to misdiagnosis and inappropriate treatment in adults, which presents challenges during thoracic surgical interventions. What is New: • Azygos lobe in children may be complicated with other congenital abnormalities. • There is no evidence that azygos lobe is associated with recurrent infections. • After appropriate anti-infective treatment, those children with azygos lobe infections could be clinically cured.
An azygos lobe is a rare anatomic variant of the lung which may be misdiagnosed as other pathological conditions. There is a dearth of information on the clinical characteristics of children with azygos lobe. This study aims to summarize the clinical features of children with azygos lobe, which may be helpful to improve recognition and clinical care of those patients. Clinical findings of the children with imaging findings of azygos lobe were collected and analyzed. In this study, 50 children with azygos lobe were included. A total of 28% cases were found to have azygos lobe incidentally. The remaining 72% cases were diagnosed when they presented with respiratory symptoms including cough (36%), fever (34%), wheezing (18%), dyspnea (14%), and cyanosis (8%). Congenital heart disease, Down syndrome, and other respiratory malformations were also found in a small proportion of these patients. Only 7 (14%) patients suffered from azygos lobe infection and were clinically cured after reasonable anti-infective treatment. Compared with the non-infected group, no valuable risk factors were found to be related to azygos lobe infection. All children who had azygos lobe infections responded to appropriate antibiotics therapy. There was no evidence that an azygos lobe was associated with recurrent infections. Conclusion: The clinical characteristics of children with azygos lobe are nonspecific and diagnosis relies on chest imaging. Some congenital abnormalities may be complicated with azygos lobe. It is reasonable to keep watch over those patients without symptoms. What is Known: • An azygos lobe is a congenital variation of the lung. • Azygos lobe can mimic various pathological conditions leading to misdiagnosis and inappropriate treatment in adults, which presents challenges during thoracic surgical interventions. What is New: • Azygos lobe in children may be complicated with other congenital abnormalities. • There is no evidence that azygos lobe is associated with recurrent infections. • After appropriate anti-infective treatment, those children with azygos lobe infections could be clinically cured.