The patient was a full-term male infant who underwent a trans-abdominal patch repair of a prenatally diagnosed congenital diaphragmatic hernia (CDH) on day of life 2 (figure 1). He was discharged home on day 45, requiring nasal cannula and an echocardiogram consistent with pulmonary artery stenosis. On outpatient follow-up, his respiratory symptoms resolved by day 61, and his supplemental oxygen support was discontinued. Subsequent chest X-rays were notable for a dense opacity, concerning for left upper lobe collapse (figure 2). On further evaluation with CT on day 145, left thymic hyperplasia was diagnosed. The patient remains asymptomatic on day 208 with slow involution of his thymus (figure 3).
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