PMC2799641_01
Bilateral pulmonary agenesis.. A. Ultrasound examinations at 31 + 2 weeks of gestation show collapsed thoracic cavity with diaphragmatic eventration. Intact diaphragm (arrow) was noted between elevated liver and narrow thoracic cavity. Right diaphragm was more displaced cephalad than left diaphragm. As result, heart and liver are shown on same plane as axial view.. B. Fetal MRI study on sagittal and coronal views at 35 + 2 weeks of gestation demonstrates decreased volume of thoracic cage, associated with bilateral elevation of diaphragm without any defect. Abruptly ending trachea (arrow) is noted.. C. Postmortem infantogram shows bell-shaped thoracic cage with diaphragmatic eventration.. D. On autopsy findings of thoracic cavity, there are no other structures except for heart, vessels (including aorta), and bilateral masses of fat tissue.
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An ultrasound examination performed on the day of the first visit at our institute demonstrated an elevated diaphragm, raising the suspicion of associated lung abnormalities (Fig. 1A). Moreover, no definite lung was identified and the trachea ended blindly near the level of the cricoid cartilage without bronchial branching (Fig. 1B). A postmortem infantogram was taken and the results of the study were consistent with the prenatal diagnosis (Fig. 1C). A complete agenesis of both lungs was identified along with the absence of lung tissue and bronchial rudiments (Fig. 1D).