The most likely diagnosis in a newborn with a radio-opaque shadow and an air-fluid level in the chest, along with a hemivertebra of the 6th thoracic vertebra on a plain x-ray, is:

Question

Image below highlights jugular foramen. Which of the following structures do not pass through the marked structure “A”?

Answer 1

This question gives three clues together: a cystic shadow in a newborn's chest, an air-fluid level inside that shadow, and a hemivertebra at T6. Put together, these point to a cyst that shares its origin with both the gut and the spinal column.

Congenital diaphragmatic hernia: shows bowel loops in the chest with a gas pattern and a shifted mediastinum, but there is no link to a vertebral defect, so this does not fit.
Esophageal duplication cyst: a foregut duplication cyst of the neurenteric type forms when the notochord and gut fail to separate fully in early life. It can open into the esophagus, so it fills with air and fluid, and the same defect leaves a hemivertebra or spina bifida nearby. This matches every clue in the question.
Bronchogenic cyst: comes from the breathing-tube side of the foregut, usually sits near the carina, and almost never connects to the airway or gut. Without that connection it stays fluid-filled with no air level, and it carries no link to vertebral anomalies.
Staphylococcal pneumonia: causes patchy shadowing and pneumatoceles from infection, not a single cyst tied to a spinal defect.

The air-fluid level plus the hemivertebra is the signature of split notochord syndrome, which produces a foregut duplication cyst of the esophageal/neurenteric type. This is why esophageal duplication cyst fits better than bronchogenic cyst, which some older keys list for this question.

Let's summarize:

An air-fluid level in a chest cyst means the cyst opens into the gut or esophagus.
A hemivertebra next to a chest cyst points to a shared notochord-gut origin, seen in neurenteric/esophageal duplication cysts, not in bronchogenic cysts.

So the most likely diagnosis is an esophageal duplication cyst.

Answer 2

This question gives three clues together: a cystic shadow in a newborn's chest, an air-fluid level inside that shadow, and a hemivertebra at T6. Put together, these point to a cyst that shares its origin with both the gut and the spinal column.

Congenital diaphragmatic hernia: shows bowel loops in the chest with a gas pattern and a shifted mediastinum, but there is no link to a vertebral defect, so this does not fit.
Esophageal duplication cyst: a foregut duplication cyst of the neurenteric type forms when the notochord and gut fail to separate fully in early life. It can open into the esophagus, so it fills with air and fluid, and the same defect leaves a hemivertebra or spina bifida nearby. This matches every clue in the question.
Bronchogenic cyst: comes from the breathing-tube side of the foregut, usually sits near the carina, and almost never connects to the airway or gut. Without that connection it stays fluid-filled with no air level, and it carries no link to vertebral anomalies.
Staphylococcal pneumonia: causes patchy shadowing and pneumatoceles from infection, not a single cyst tied to a spinal defect.

The air-fluid level plus the hemivertebra is the signature of split notochord syndrome, which produces a foregut duplication cyst of the esophageal/neurenteric type. This is why esophageal duplication cyst fits better than bronchogenic cyst, which some older keys list for this question.

Let's summarize:

An air-fluid level in a chest cyst means the cyst opens into the gut or esophagus.
A hemivertebra next to a chest cyst points to a shared notochord-gut origin, seen in neurenteric/esophageal duplication cysts, not in bronchogenic cysts.

So the most likely diagnosis is an esophageal duplication cyst.

The most likely diagnosis in a newborn with a radio-opaque shadow and an air-fluid level in the chest, along with a hemivertebra of the 6th thoracic vertebra on a plain x-ray, is:

Show Hint

The Correct Option is B

Solution and Explanation

Questions Asked in NEET (PG) exam