Recurrent, persistent pneumothorax in a neonate: A cryptic cause

Newborns, especially preterms, have a higher risk of developing pneumothorax. We report a 33-week preemie who presented with recurrent, persistent right pneumothorax, which failed to resolve with standard treatment. The child underwent surgical removal of a suspect nonexpanding upper lobe of the right lung with clinical improvement. Histopathology was atypical but nearly consistent with congenital pulmonary airway malformation (CPAM). This report highlights the clinicopathological discordance noted and aims to draw an embryological explanation toward the atypical histomorphology of CPAM in preemies.