CCAM (Congenital Cystic Adenomatoid Malformation) is a group of multicystic or noncystic mass caused by abnormal proliferation of terminal respiratory bronchioles. Its incidence is 25% of bronchopulmonary malformations. It is often present with respiratory distress and can be life-threatening. Radiology has an important role in distinguishing pulmonary congenital lucency lesion because it has different treatment. CT provides more detailed information concerning chest anatomy and pathology than a chest radiograph. To report concordance radiologic and histopathologic finding of CCAM and distinguish CCAM from CLE (Congenital Lobar Emphysema). 2-days-old female neonates presented to the Sardjito Hospital with respiratory distress and cough. It has a prenatal history of right lung cyst at 24 weeks. Chest radiograph showed one large cyst in right upper lobe measuring 3,5 cm in diameter with smaller cyst seen along its periphery. Shifting mediastinal to the left appeared. CCAM was diagnosed based on chest radiograph, but CT scan admitted in another hospital showed CLE. Occasionally, to differ CCAM with CLE is difficult. However, if we look at that lesion more carefully in CT scan, there is no pulmonary vascular marking within the lesion. The thickness of lucency lesion is 3 mm, so it is indicated the cyst, not bullous emphysematous which its wall thickness is less than 1 mm. Not easy to differ CCAM with CLE. No finding of pulmonary vascular marking and the thickness of focal lucency lesion play an important role to distinguish it.