Medical History A 5-month-old male infant is brought to the emergency department for fever of 100,4 °F (38 °C) at home, productive cough, worsening of the respiratory pattern (with signs of strong respiratory effort) and a micropapular rash on the face and thorax for 12 days. Nasal saline lavage and a short-acting β-agonist prescribed, without success. Chest X-ray (image 3) and ultrasound performed in the gestation period, raised the suspicion of lung malformation, confirmed by fetal MRI (image 1). The baby was born at full term and was appropriate for gestational age, with a birth weight of 3.730g. There is a history of respiratory distress, requiring supplemental oxygen and CPAP within the first hours of life. The physician ordered a thorax CT (Image 2). Fetal magnetic resonance (MRI), T2-weighted, showing uterus with an only fetus on longitudinal position, cephalic presentation, back turned right. (A) coronal view; (B) sagittal view.High-resolution computed tomography (HRCT) of the thorax, axial view, lung window.Chest radiographs, anteroposterior (A) and lateral (B) views. Question:Based on the images and the clinical scenario, which of the following is the most likely diagnosis? Bronchopulmonary sequestration Congenital pulmonary airway malformation Bronchial atresia Bronchogenic cyst Test Question (Brazilian Society of Pediatrics) The presence of some cysts of varied dimensions on the thorax CT, the bigger one measuring 2cm, in the right lower lung of a newborn with a few hours of life is compatible with the diagnosis of: Bronchial atresia Bronchogenic cyst Right sided congenital diaphragmatic hernia Cystic adenomatoid malformation Time is Up! Time's up
