Comparative analysis in ultrastructure and histological types for congenital cystic adenomatoid malformation

Objective To explore relationship between imaging classification and pathological type, and the electron microscopic ultrastructure by observing the ultrastructural features of congenital cystic adenomatoid malformation(CCAM). Methods Children with CCAM in the Guangdong Women and Children Hospital from May 2014 to November 2014, were analyzed, imaging classification was performed according to enhanced Computed Tomography (CT) scanning, and the surgical specimens were stained by HE and scanning electron microscope was used to observe the tissue structures of various of CCAM. Results Eight cases were enrolled in this research (5 boys and 3 girls), and the mean age of surgery was (5.4±1.1) month old.According to the features of enhanced CT scanning, there were 2 cases of the type-Ⅰ, and the other 3 cases of type-Ⅱ, and 3 cases of type-Ⅲ; According to the characteristics of the pathological types, there was 1 case of type-Ⅰ, 4 cases of type-Ⅱ, and the other 3 cases of type-Ⅲ.There was 1 case which classified as type-Ⅰ by CT, however classified as type-Ⅱ by pathological typing.The findings of CT features were in complete correspondence with the pathological types in the rest cases.Electron microscopic findings showed the alveolar spaces were enlarged, the alveolar cells were reduced, the lamellar bodies were decreased and immature and microvilli were also decreased.There was no significant difference between ⅠandⅡ type under the viewpoint of electron microscope.The common features between typeⅠ, and type Ⅱ included that the alveolar space was enlarged, the alveolar space had been pressed between enlarged alveolar space, the alveolar cell were decreased and immature, and fibrous hypertrophy was also found. Conclusions There are differences between ultrastructural analysis and clinical pathological typing which suggests the clinical importance of the electron microscopy ultrastructural analysis combined with pathology for typing.There need further clinical and laboratory studies, especially the combination of microscopy-electrical control microscope for typing with related predictive models for follow-up of CCAM. Key words: Congenital cystic adenomatoid malformation; Electron microscopy ultrastructural analysis; Pathology