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Agafonov GM, Petrov AS, Atyukov MA, Novikova OV, Zemtsova IY, Dvorakovskaya IV, Yablonsky PK. [Right upper lobe pulmonary sequestration as a rare cause of recurrent spontaneous pneumothorax]. Khirurgiia (Mosk) 2024:102-109. [PMID: 38258696 DOI: 10.17116/hirurgia2024011102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
A 19-year-old patient after previous wedge resection of the right upper pulmonary lobe a year ago urgently admitted with recurrent right-sided spontaneous pneumothorax. According to standard management of spontaneous pneumothorax, we performed diagnostic thoracoscopy and drainage of the right pleural cavity with regular X-ray examinations. However, these measures were ineffective. The patient was scheduled for surgery, and we intraoperatively observed an unusual cause of pneumothorax. Thus, we present spontaneous pneumothorax following right upper lobe pulmonary sequestration. The uniqueness of this case is associated with unusual manifestation and non-standard localization of rare lesion. A few cases of pneumothorax in similar patients are described in the world literature. The key limiting factor in diagnosis of such defects (identification of aberrant vessel supplying abnormal lung parenchyma) is the lack of routine CT angiography in patients diagnosed with pneumothorax. That is why CT changes were interpreted as postoperative ones, and the true cause was established only during redo surgery. A thorough inspection of the pleural cavity and alertness regarding unusual appearance of the right upper pulmonary lobe made it possible to suggest a non-standard diagnosis, avoid complications (bleeding from afferent vessel) and perform adequate lung resection.
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Affiliation(s)
- G M Agafonov
- Saint-Petersburg State University, St. Petersburg, Russia
| | - A S Petrov
- Saint-Petersburg State University, St. Petersburg, Russia
- Saint-Petersbursg City Clinical Hospital No. 2, St. Petersburg, Russia
| | - M A Atyukov
- Saint-Petersbursg City Clinical Hospital No. 2, St. Petersburg, Russia
| | - O V Novikova
- Saint-Petersburg State University, St. Petersburg, Russia
- Saint-Petersbursg City Clinical Hospital No. 2, St. Petersburg, Russia
| | - I Yu Zemtsova
- Saint-Petersburg State University, St. Petersburg, Russia
- Saint-Petersbursg City Clinical Hospital No. 2, St. Petersburg, Russia
| | - I V Dvorakovskaya
- Pavlov St. Petersburg First State Medical University, St. Petersburg, Russia
| | - P K Yablonsky
- Saint-Petersburg State University, St. Petersburg, Russia
- Saint-Petersbursg City Clinical Hospital No. 2, St. Petersburg, Russia
- Saint-Petersburg State Research Institute of Phthisiopulmonology, St. Petersburg, Russia
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2
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Pederiva F, Rothenberg SS, Hall N, Ijsselstijn H, Wong KKY, von der Thüsen J, Ciet P, Achiron R, Pio d'Adamo A, Schnater JM. Congenital lung malformations. Nat Rev Dis Primers 2023; 9:60. [PMID: 37919294 DOI: 10.1038/s41572-023-00470-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/03/2023] [Indexed: 11/04/2023]
Abstract
Congenital lung malformations (CLMs) are rare developmental anomalies of the lung, including congenital pulmonary airway malformations (CPAM), bronchopulmonary sequestration, congenital lobar overinflation, bronchogenic cyst and isolated congenital bronchial atresia. CLMs occur in 4 out of 10,000 live births. Postnatal presentation ranges from an asymptomatic infant to respiratory failure. CLMs are typically diagnosed with antenatal ultrasonography and confirmed by chest CT angiography in the first few months of life. Although surgical treatment is the gold standard for symptomatic CLMs, a consensus on asymptomatic cases has not been reached. Resection, either thoracoscopically or through thoracotomy, minimizes the risk of local morbidity, including recurrent infections and pneumothorax, and avoids the risk of malignancies that have been associated with CPAM, bronchopulmonary sequestration and bronchogenic cyst. However, some surgeons suggest expectant management as the incidence of adverse outcomes, including malignancy, remains unknown. In either case, a planned follow-up and a proper transition to adult care are needed. The biological mechanisms through which some CLMs may trigger malignant transformation are under investigation. KRAS has already been confirmed to be somatically mutated in CPAM and other genetic susceptibilities linked to tumour development have been explored. By summarizing current progress in CLM diagnosis, management and molecular understanding we hope to highlight open questions that require urgent attention.
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Affiliation(s)
- Federica Pederiva
- Paediatric Surgery, "F. Del Ponte" Hospital, ASST Settelaghi, Varese, Italy.
| | - Steven S Rothenberg
- Department of Paediatric Surgery, Rocky Mountain Hospital for Children, Denver, CO, USA
| | - Nigel Hall
- University Surgery Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Hanneke Ijsselstijn
- Department of Paediatric Surgery and Intensive Care, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Kenneth K Y Wong
- Department of Surgery, University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Jan von der Thüsen
- Department of Pathology and Clinical Bioinformatics, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Pierluigi Ciet
- Departments of Radiology and Nuclear Medicine and Respiratory Medicine and Allergology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
- Department of Radiology, University of Cagliari, Cagliari, Italy
| | - Reuven Achiron
- Department of Obstetrics and Gynecology, Fetal Medicine Unit, The Chaim Sheba Medical Center Tel-Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Adamo Pio d'Adamo
- Laboratory of Medical Genetics, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - J Marco Schnater
- Department of Paediatric Surgery, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
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Mughrabi A, Fennelly J, Fandreyer F, Fleisher J. Unravelling the mystery of a rare infection: a challenging case of pulmonary sequestration with Mycobacterium avium complex and the importance of a thorough microbiological investigation. BMJ Case Rep 2023; 16:e255346. [PMID: 37699740 PMCID: PMC10503325 DOI: 10.1136/bcr-2023-255346] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2023] [Indexed: 09/14/2023] Open
Abstract
Pulmonary sequestration is a rare congenital condition. It is a dysplastic lung tissue with a separate systemic blood supply and without a bronchial tree connection. The emergence of a superimposed infection can lead to its diagnosis, such as Staphylococcus aureus, Pseudomonas aeruginosa, Nocardia asteroids and Aspergillus sp pneumonia. Mycobacterium avium complex (MAC) superimposed disease is exceedingly rare. We report a case of a man in his third decade without known medical disorders presenting with a persistent cough. After an extensive microbiological workup, an MAC infection was diagnosed. An elevated carbohydrate antigen 19-9 (CA 19-9) was also noted. He was treated with antimycobacterial therapy and lobectomy resulting in clinical improvement and CA19-9 normalisation. This case illustrates the value of comprehensive microbiological investigations in patients with chronic respiratory symptoms and imaging findings that are not typical of bacterial pneumonia. Clinical studies remain needed to investigate the utility of CA 19-9 in a scoring system to guide MAC therapy.
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Affiliation(s)
- Abdallah Mughrabi
- Department of Internal Medicine, St. Elizabeth's Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | | | | | - Jorge Fleisher
- Division of Infectious Diseases, Department of Medicine, St. Elizabeth's Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachussets, USA
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Muri J, Durcová B, Garchar A, Makovický P, Vrbenská A, Kamarád V. Intrapulmonary sequestration with destructive pneumonia and life-threatening hemoptysis in an adult patient: a case report. Rozhl Chir 2023; 102:23-27. [PMID: 36809891 DOI: 10.33699/pis.2023.102.1.23-27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The article reports the case of a patient with bronchopulmonary sequestration complicated by destructive actinomycotic inflammation leading to life-threatening hemoptysis. It was an adult patient with the history of repeated right-sided pneumonia the cause of which had not been investigated in detail in the past. Only hemoptysis, which appeared as a complication, led to a closer investigation of the background of repeated right-sided pneumonia. CT scan of the chest revealed a lesion of the middle lobe of the right lung with anomalous vascularization - compatible with intralobar sequestration. Initially, conservative antibiotic treatment of pneumonia was provided at a local clinic. Embolization of the afferent vessels of the sequestrum was indicated due to persistent hemoptysis; this led to a reduction of its blood supply, proven by a follow-up CT examination of the chest. Clinically, the hemoptysis subsided. Three weeks later, the hemoptysis reocurred. The patient was acutely hospitalized at a specialized thoracic surgery department where shortly after admission, hemoptysis progressed to life-threatening hemoptea. Urgent middle lobectomy of the right lung was approached via thoracotomy to treat the source of bleeding. The case describes unrecognized bronchopulmonary sequestration as a possible cause of recurrent ipsilateral pneumonia in adulthood; additionally, it emphasizes the possible risks associated with a pathologically altered tissue microenvironment of pulmonary sequestration, and the need for surgical removal in all indicated cases.
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Nuñez-Paucar H, Atamari-Anahui N, Valera-Moreno C. Congenital pulmonary malformations in children in a pediatric hospital in Peru, 2010-2020. Bol Med Hosp Infant Mex 2023; 80:235-241. [PMID: 37703573 DOI: 10.24875/bmhim.23000055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 07/20/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Congenital pulmonary malformations (CPMs) are rare in children. This study aimed to describe the clinical, imaging characteristics, and treatment of patients with this pathology. METHODS We conducted a descriptive and retrospective study with data from patients with CPMs diagnosed at Instituto Nacional de Salud del Niño-Breña (Lima-Peru), from January 2010 to December 2020. We described CPM clinical and imaging characteristics, type and treatment. RESULTS The sample was formed of 70 patients. The median age was 29 months (range 15 days-14 years) and the male/female ratio was 1.4. The chest tomography found parenchymal involvement in 50 (71.4%) cases and mixed involvement (parenchymal and vascular) in 18 (25.7%) cases. Congenital malformation of the pulmonary airway was present in 39 (55.7%) cases, followed by bronchogenic cyst in 10 (14.3%), intralobar pulmonary sequestration in 9 (12.9%), and extralobar pulmonary sequestration in 7 (10%). Lobectomy was performed in 61 (87.1%) cases, cystectomy in 5 (7.1%), segmentectomy in 2 (2.9%), and embolization in 2 (2.9%). The most frequent post-operative complication was pneumonia, found in 9 (12.9%) cases. The median hospital stay was 26 days. No patient died during hospitalization. CONCLUSIONS In our institution, the most frequent CPM was congenital malformation of the pulmonary airway, and lobectomy was the most frequently performed surgical procedure. CPMs represent a diverse group of disorders of lung development with varied imaging patterns and clinical manifestations.
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Affiliation(s)
- Héctor Nuñez-Paucar
- Instituto Nacional de Salud del Niño-Breña
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola. Lima, Peru
| | - Noé Atamari-Anahui
- Instituto Nacional de Salud del Niño-Breña
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola. Lima, Peru
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6
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A Cunha S, Klepetko W. Intrapulmonary Lung Sequestration. Port J Card Thorac Vasc Surg 2022; 29:85. [PMID: 36197824 DOI: 10.48729/pjctvs.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/25/2022] [Indexed: 06/16/2023]
Abstract
A 16-year-old female, without relevant previous medical history, presented with 1 year episodic and progressive hemoptysis. CT scan revealed an abnormal blood supply from the descending thoracic aorta to the left lower lobe, the later presenting with significant signs of hyperperfusion. Therapy consisted of ligation of the anomalous vessel followed by left lower lobe lobectomy. Lung sequestration is a rare congenital pulmonary malformation, mostly diagnosed in childhood. The typical symptoms are recurrent pulmonary infections or productive cough and only in rare situations severe hemoptysis occurs. Preoperative planning with CT or MR angiography is important to identify the aberrant blood supply. The treatment of choice is surgical ligation of the feeding vessel in combination with lung resection.
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Affiliation(s)
- Sara A Cunha
- Cardiothoracic Surgery, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Walter Klepetko
- Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria
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Ghalib S, Chopra A, Fantauzzi JP, Nabagiez JP, Tiwari A. A Young Woman With Recurrent Episodes of Fever and Cough. Chest 2021; 160:e25-e28. [PMID: 34246384 DOI: 10.1016/j.chest.2021.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 12/30/2020] [Accepted: 01/11/2021] [Indexed: 11/15/2022] Open
Abstract
CASE PRESENTATION A 19-year-old woman presented to pulmonary clinic with recurrent episodes of fevers and productive cough over the last 2 years. She was diagnosed with several episodes of respiratory infection that required antibiotic therapy. Her symptoms improved transiently after antibiotic therapy. However, symptoms continued to recur every 1 to 2 months. She denied any close TB contacts or travel outside the United States. She was a nonsmoker and had no history of immunodeficiency. There was no history of cystic fibrosis or any foreign body aspiration.
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Affiliation(s)
- Sana Ghalib
- Division of Pulmonary and Critical Care Medicine, Albany Medical Center, Albany, NY.
| | - Amit Chopra
- Division of Pulmonary and Critical Care Medicine, Albany Medical Center, Albany, NY
| | | | - John P Nabagiez
- Division of Thoracic Surgery, Albany Medical Center, Albany, NY
| | - Anupama Tiwari
- Division of Pulmonary and Critical Care Medicine, Albany Medical Center, Albany, NY
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8
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Kanwar SS, Downey SA, Tandon YK. An Unusual Case of Lung Consolidation: Thinking Beyond Pneumonia. Am J Med 2021; 134:477-481. [PMID: 32997979 DOI: 10.1016/j.amjmed.2020.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 08/25/2020] [Accepted: 08/25/2020] [Indexed: 11/19/2022]
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9
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Chen Y, Li LQ, Ge YL, Li WQ, Zhang Q, Zhang HF, Zhang S, Zhu XY, Zhang JB, Chen QC, Jing Q, Lu Y, Liu Y, Sun Y, Min P, Hou LL. Elevated Leukocytes Combined with Left Lung Consolidation on Chest Computed Tomography (CT) Scan in an Adult Patient Firstly Misdiagnosed as Pneumonia and Finally Diagnosed as Pulmonary Sequestration by Enhanced CT Scan and CT Angiography: a Case Report and Literature Review. Clin Lab 2021; 66. [PMID: 32255298 DOI: 10.7754/clin.lab.2019.190828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Pulmonary sequestration is an uncommon pulmonary disorder. We presented an adult case with recurrent pulmonary infection firstly misdiagnosed as pneumonia, which proved as pulmonary sequestration by enhanced CT scan and CT angiography. METHODS Appropriate laboratory tests, chest CT scan, bronchoscopy, and CT angiography were performed for diagnosis. RESULTS The white blood cells detected by routine blood test were 11.8 x 109/L, the plain chest CT scan showed the volume of the lower lobe of the left lung decreased and the density increased. Enhanced CT and maximum intensity projection (MIP) algorithms were used for three-dimensional (3D) reconstruction of the images: no abnormally enhanced shadows were seen in the reduced lower lobe of the left lung, and tortuous vascular shadows were seen in the mediastinum. Bronchoscopy showed a narrowing of the opening in the dorsal segment of the lower lobe of the left lung. Thoracic aortography revealed an abnormal arterial supply to the lower left lung, the pathological results of thoracoscopic resection of the lower left lung were pulmonary sequestration. CONCLUSIONS Pulmonary consolidation may be more than a simple pulmonary infection. Physicians should consider the possibility of pulmonary sequestration in patients with recurrent or refractory pneumonia. Enhanced CT findings of abnormal blood vessel supply are helpful for pulmonary sequestration diagnosis, and CT angiography is the gold standard for diagnosis.
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Kampolis CF, Damaskos C, Loukeri AA, Garmpis N, Garmpi A, Tomos I, Spartalis E, Dimitroulis D, Patsouras A, Douskou M, Papiris SA, Tomos P. Primary Hemangiopericytoma Arising in Extralobar Pulmonary Sequestration: A Coincidence or Two Rare Disorders? In Vivo 2019. [PMID: 31662549 DOI: 10.2173/invivo.11574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
BACKGROUND/AIM Extralobar pulmonary sequestration (EPS) is an unusual congenital defect characterized by the presence of non-functioning lung tissue receiving arterial supply from the systemic arteries. Primary hemangiopericytoma (HPC) is an uncommon potentially malignant tumor of vascular origin that usually involves the soft tissue of the extremities or retroperitoneum, but extremely rarely affects the lung. We present the rare case of a primary pulmonary HPC arising in an EPS. CASE REPORT A 65-year-old woman, with dyspnea and pleuritic chest pain, was referred for further investigation. Radiological evaluation demonstrated a well-circumscribed mass above the right hemidiaphragm, receiving its arterial supply from the descending thoracic aorta. The patient underwent a right posterolateral thoracotomy and a middle lobectomy. The intraoperative finding was a well-encapsulated solid mass. The histological evaluation described HPC. RESULTS The patient remains fit and healthy. CONCLUSION Pulmonary HPC can arise in EPS. Surgical excision is the treatment of choice.
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Affiliation(s)
- Christos F Kampolis
- Department of Pathophysiology, University of Athens, Medical School, Athens, Greece
| | - Christos Damaskos
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Angeliki A Loukeri
- Respiratory Care Unit, Sotiria Hospital, General Hospital of Chest Diseases, Athens, Greece
| | - Nikolaos Garmpis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Tomos
- Second Pulmonary Medicine Department, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleftherios Spartalis
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Dimitroulis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Spyros A Papiris
- Second Pulmonary Medicine Department, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Periklis Tomos
- Department of Thoracic Surgery, Attikon University Hospital, Athens Medical School, National and Kapodistrian University of Athens, Chaidari, Greece
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Abstract
RATIONALE The presence of a mediastinal neurilemmoma accompanied by intrapulmonary sequestration is a rare occurrence. The clinical symptoms of a neurilemmoma depend on the site of the tumor. Diagnosis of pulmonary sequestration mainly depends on the presence of aberrant feeding arteries. PATIENT CONCERNS A 78-year-old woman was admitted to our hospital with a mediastinal space-occupying lesion of 50 years. Computed tomography and magnetic resonance imaging showed 2 roundish low-density shadows in the left posterior mediastinum. DIAGNOSIS The pathological findings of the upper cystic mass support the diagnosis of neurilemmoma. A branch of aorta was found supplying blood to the lower mass; it was considered a pulmonary sequestration. INTERVENTIONS Left-sided thoracotomy was planned to remove the chest space-occupying lesions. Two masses were completely removed. Severe adhesion between the left lower lobe and the diaphragm was successfully separated, the aberrant feeding vessel was properly managed, and the lower lobe was resected completely. OUTCOMES The patient experienced remission of symptoms, had no significant postoperative complications, and was discharged from the hospital. LESSONS Special attention should be paid to neurological involvement of the neurilemmoma and the fragile feeding arteries of the intrapulmonary sequestration. Early diagnosis and treatment are important in such cases.
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Affiliation(s)
- Yang Yue
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin
| | - Hua Xin
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin
| | - Bao-Cen Xu
- Department of Thoracic Surgery, People's Hospital of Xing’an League, Ulanhot City, Inner Mongolia autonomous region, China
| | - Le-Ning Zhang
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin
| | - Wei Zhao
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin
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Dong Q, Zhao JP, Zhang L, Morelli J, Zhang ZK, Zhang P. STARD-compliant article: Comparison of pulmonary sequestrations with thoracic and abdominal aortic arterial supply. Medicine (Baltimore) 2019; 98:e16220. [PMID: 31277133 PMCID: PMC6635279 DOI: 10.1097/md.0000000000016220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Pulmonary sequestrations (PS) are typically supplied by a vessel originating from thoracic aorta, or abdominal aorta. Differences in imaging features between these PS subtypes have not been described.To analyze the imaging features of PS with arterial supply from the thoracic and abdominal aorta.Retrospectively, 23 pathologically proven cases of pulmonary sequestration were analyzed and compared based on the site of feeding artery origin.In 21 cases (21/23), the PS was soft tissue density. 1 (1/23) PS was purely cystic and another heterogeneous with both cystic and solid components (1/23). In 16/23 cases, the feeding vessel(s) arose from the thoracic aorta (male:female ratio 1:7) and in 7/23 cases from the abdominal aorta (male:female ratio 4:3). Feeding vessels from the thoracic aorta were duplicated in 7/16 cases. PS location (P <.05) and size (P <.001) differed based on the origin of the feeding vessel (thoracic aorta: 14/16 left lower lobe, mean volume 962.97 mL; abdominal aorta: 3/7 left lower lobe, mean volume 1120.89 mL). The feeding arteries themselves differed in size depending on their site of origin (thoracic aorta: mean diameter 7.0mm ± 2.7 mm, mean length 44.6mm ± 10.9 mm; abdominal aorta: mean diameter 3.3mm ± 0.6 mm, mean length 103.6mm ± 34.5 mm).PS size and distribution differ depending upon the site of feeding vessel origin as does the size of the feeding vessel itself.
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Affiliation(s)
- Qian Dong
- Department of Radiology, The third Hospital of Hebei Medical University, Hebei Province Biomechanical Key Laborary of Orthopedics, Shijiazhuang, Hebei, China
| | - Jing Pin Zhao
- Department of Radiology, The third Hospital of Hebei Medical University, Hebei Province Biomechanical Key Laborary of Orthopedics, Shijiazhuang, Hebei, China
| | - Li Zhang
- Department of Radiology, The third Hospital of Hebei Medical University, Hebei Province Biomechanical Key Laborary of Orthopedics, Shijiazhuang, Hebei, China
| | - John Morelli
- Department of Radiology, St. Johns Medical Center, Tulsa, OK
| | - Ze Kun Zhang
- Department of Radiology, The third Hospital of Hebei Medical University, Hebei Province Biomechanical Key Laborary of Orthopedics, Shijiazhuang, Hebei, China
| | - Ping Zhang
- Department of Radiology, The third Hospital of Hebei Medical University, Hebei Province Biomechanical Key Laborary of Orthopedics, Shijiazhuang, Hebei, China
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13
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Yangui F, Charfi M, Abouda M, Charfi MR. Pulmonary sequestration in a healthy teenage girl. Tunis Med 2019; 97:604-605. [PMID: 31729713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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14
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Pissarra D, Salgueiro E, Oliveira AC, Malangatana G, Pinho P, Casanova J. Pulmonary Sequestration Supplied By The Circumflex Artery - A Rare Case Report. Rev Port Cir Cardiotorac Vasc 2019; 26:159-162. [PMID: 31476820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Indexed: 06/10/2023]
Abstract
Pulmonary sequestration (PS) is a rare congenital malformation, even more when its arterial supply is a coronary artery. We present a case of a 68-year-old man admitted in the emergency room with an acute coronary syndrome and no evidence of significant coronary disease. Instead, he had an abnormal branch from the circumflex coronary artery nourishing a mass in the left lower pulmonary lobe. A coronary steal phenomenon was proposed to explain the clinical presentation. An anterior left thoracotomy with ligation of the abnormal branch and atypical resection of the lung segment comprising the sequestration was performed.
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Affiliation(s)
- Diana Pissarra
- Department of Cardiothoracic Surgery, S. João Hospital, Oporto, Portugal
| | - Elson Salgueiro
- Department of Cardiothoracic Surgery, S. João Hospital, Oporto, Portugal
| | | | | | - Paulo Pinho
- Department of Cardiothoracic Surgery, S. João Hospital, Oporto, Portugal
| | - Jorge Casanova
- Department of Cardiothoracic Surgery, S. João Hospital, Oporto, Portugal
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Li X, He W, Li J, Ouyang R, Chen P, Peng H, Zong D. Pulmonary sequestration associated with increased serum tumor markers and elevated standard uptake value level in PET/CT: A case report and literature review. Medicine (Baltimore) 2018; 97:e11714. [PMID: 30075576 PMCID: PMC6081182 DOI: 10.1097/md.0000000000011714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Pulmonary sequestration (PS) is a congenital pulmonary malformation wherein a piece of tissue that ultimately develops into lung tissue is not attached to the pulmonary arterial blood supply, sometimes it is difficult to diagnosis with no specific laboratory tests, discover an abnormal blood supply from aorta by imaging tests is a key step in diagnose. PATIENT CONCERNS A 54-year-old male smoker presented with cough, expectoration and blood in the sputum. DIAGNOSES Computed tomography (CT) shows lesion in right lung, moderate standard uptake value (SUV) elevation of position-emission tomography/computed tomography (PET/CT) in a part of the lesion, and an increased (1,3)-β-D-glucan assay (G test), Galactomannan enzyme immune-assay (GM test) and tumor marker level, biopsy of lung in different times produced inconclusive results, then finally diagnose of pulmonary sequestration is made by observing an abnormal blood supply from the thoracic aorta and volume change of mass. INTERVENTIONS The patient refused lower lobectomy which is the main treatment of PS. He was discharged with oral hemostatic and was advised to undergo regular medical checkups. OUTCOMES The patient has been followed for a year under an outpatient regimen. Symptoms of the cough and expectoration were relieved, however, blood in the sputum remains unchanged. LESSONS It suggests the need for criteria for a thorough diagnostic work-up. It put emphasis on the importance of considering PS as part of the diagnosis of a lesion in the lung disease and underscore the blood supply of mass. Bronchoscopy or pulmonary lobectomy and follow up of the patient are important for patients diagnosed with pulmonary sequestration.
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Affiliation(s)
| | - Wenlong He
- Department of Respiratory Medicine, the Second Xiangya Hospital; Research Unit of Respiratory Disease; Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan, China
| | - Jinhua Li
- Department of Respiratory Medicine, the Second Xiangya Hospital; Research Unit of Respiratory Disease; Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan, China
| | - Ruoyun Ouyang
- Department of Respiratory Medicine, the Second Xiangya Hospital; Research Unit of Respiratory Disease; Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan, China
| | - Ping Chen
- Department of Respiratory Medicine, the Second Xiangya Hospital; Research Unit of Respiratory Disease; Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan, China
| | - Hong Peng
- Department of Respiratory Medicine, the Second Xiangya Hospital; Research Unit of Respiratory Disease; Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan, China
| | - Dandan Zong
- Department of Respiratory Medicine, the Second Xiangya Hospital; Research Unit of Respiratory Disease; Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan, China
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Riley JS, Urwin JW, Oliver ER, Coleman BG, Khalek N, Moldenhauer JS, Spinner SS, Hedrick HL, Adzick NS, Peranteau WH. Prenatal growth characteristics and pre/postnatal management of bronchopulmonary sequestrations. J Pediatr Surg 2018; 53:265-269. [PMID: 29229484 PMCID: PMC5828905 DOI: 10.1016/j.jpedsurg.2017.11.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Accepted: 11/08/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE The prenatal natural history of intralobar and extralobar bronchopulmonary sequestrations (BPSs), including lesion growth patterns and need for prenatal intervention, have not been fully characterized. We review our series of BPSs to determine their natural history and outcomes in the context of the need for prenatal intervention. METHODS A retrospective review of the pre/postnatal course of 103 fetuses with an intralobar (n=44) or extralobar BPS (n=59) managed at a single institution between 2008 and 2015 was performed. Outcomes included prenatal lesion growth trajectory, presence of hydrops, need for prenatal intervention, survival, and postnatal surgical management. RESULTS Most extralobar (71%) and intralobar BPSs (94%) decreased in size or became isoechoic from initial to final evaluation. Peak lesion size occurred at 26-28weeks gestation. Eight fetuses developed hydrothorax, four of which (all extralobar BPSs) also developed hydrops. All four hydropic fetuses received maternal betamethasone, and three hydropic fetuses underwent thoracentesis and/or thoracoamniotic shunt placement with subsequent hydrops resolution. All fetuses survived. Forty-one intralobar (93%) and 35 extralobar BPSs (59%) were resected after birth. CONCLUSIONS BPSs tend to decrease in size after 26-28weeks gestation and rarely require fetal intervention. Lesions resulting in hydrothorax ± hydrops can be effectively managed with maternal steroids and/or drainage of the hydrothorax. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- John S Riley
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - John W Urwin
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Edward R Oliver
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Beverly G Coleman
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Nahla Khalek
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Julie S Moldenhauer
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Susan S Spinner
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Holly L Hedrick
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - N Scott Adzick
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - William H Peranteau
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
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Godshall E, Friedman S, Lesher A. Extralobar Pulmonary Sequestration with Accompanying Ipsilateral Diaphragmatic Eventration. Am Surg 2016; 82:e245-e246. [PMID: 27670535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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18
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Abstract
Pulmonary sequestration is nonfunctioning, abnormal pulmonary tissue existing inside or outside the visceral pleura. It is not connected to the tracheobronchial tree. In this study, the results of 8 patients, who were diagnosed with pulmonary sequestration and treated during hospitalization in Gülhane Military Medical Academy between 1996 and 2003, were reported. Sex, age, symptoms, diagnostic approach, operative findings, procedures and postoperative outcomes were reviewed. No postoperative complications were seen. In the long-term follow-up all patients were seen to be asymptomatic. We believe surgical resection is mandatory in order to avoid infection and destruction of the normal pulmonary parenchyma even in asymptomatic cases. Furthermore, when infection occurs, major resection such as lobectomy may be necessary rather than segmentectomy or wedge resection, which involves removal of minimal pulmonary parenchyma.
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Affiliation(s)
- Onur Genç
- Department of Thoracic Surgery, Gülhane Military Medical Academy, Etlik, Ankara 06018, Turkey
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19
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Abstract
Background and Aims: Pulmonary sequestration (PS) is a rare congenital malformation where non-functioning lung tissue is separated from the bronchial tree and vascularised with an aberrant artery from the systemic circulation. The aim of this report was to study all patients who were treated for PS at Lund University Hospital between 1994 and 2004, with emphasis on clinical presentation of the disease and evaluate the results of surgical treatment. Material and Methods: 8 cases were identified, 7 females and one male, with a mean age of 7.3 years (range 25 days — 17 years) at the time of diagnosis. Results: Out of 8 patients, seven presented with respiratory symptoms and two with congestive heart failure. Five patients had other congenitial malformations; including scimitar syndrome and congenital heart disease. All the patients underwent a successful lobectomy. There were no major postoperative complications. At a medium follow-up of 77 months all of the fully treated children were doing well. Conclusion: Respiratory and cardiovascular symptoms are the most common symptoms related to PS. The wide range of clinical symptoms may cause diagnostic problems, especially in children and young adults with concomitant congenital heart disease. Therefore PS should be considered as a differential diagnosis in children with unexplained respiratory symptoms or with signs of congestive heart failure. In patients with PS, lobectomy seems to be a good therapeutic option.
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Affiliation(s)
- A Pikwer
- The Department of Cardiothoracic Surgery, Faculty of Medicine, Lund University Hospital and Lund University, Lund, Sweden
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20
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Costa MR, Costa TR, Leite MSB, Filho FRDS, Reis AMB, Pereira BP, Oliveira AMD. Atypical presentation of intra-abdominal extralobar pulmonary sequestration detected in prenatal care: a case report. Revista Paulista de Pediatria (English Edition) 2016. [PMID: 26611889 PMCID: PMC4917277 DOI: 10.1016/j.rppede.2016.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | | | | | | | | | - Bruno Paiva Pereira
- Hospital das Clínicas, Universidade Federal de Goiás (UFG), Goiânia, GO, Brasil
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21
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Jian-Hua W, Jie C, Lan-Fang T. A 7-Year-Old Girl with Hemoptysis for 3 Days. Pediatr Ann 2016; 45:e162-4. [PMID: 27171802 DOI: 10.3928/00904481-20160322-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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22
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Obeidat N, Sallout B, ALAAli W. Isolated subdiaphragmatic extralobar pulmonary sequestration: masquerading as suprarenal mass with spontaneous resolution. CLIN EXP OBSTET GYN 2016; 43:457-459. [PMID: 27328516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Sub-diaphragmatic extralobar pulmonary sequestration (PS) is an extremely rare malformation defined as a portion of lung tissue that is totally discontinuous from the tracheobronchial tree and usually has its own pleural covering with an anomalous systemic blood supply. It is usually associated with other congenital malformations. The authors present an extremely rare case of isolated sub-diaphragmatic PS which was antenatally detected and followed up with postnatal ultrasound, where it masqueraded as a suprarenal mass; it was totally asymptomatic with spontaneous resolution at age of two years. This case emphasizes to add a differential diagnosis of malformation in congenital supra-renal masses, which remain stable in size and appearance, with possible spontaneous resolution and hence avoid immediate intervention and surgery.
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23
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Bombová J, Lubušký M. [Bronchopulmonary sequestration]. Ceska Gynekol 2016; 81:289-294. [PMID: 27882752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To describe the case of prenatal diagnosis of bronchopulmonary sequestration and compelete spontaneous antenatal regresion of the lesion. DESIGN Case report and review of the literature. SETTING Complex Cancer Center Novy Jicin, Department of Obstetrics and Gynecology Palacky University Hospital Olomouc. CASE REPORT We describe the case reports about the complete regression of a quite large bronchopulmonary sequestration during pregnancy. CONCLUSION Bronchopulmonary sequestration is usually diagnosed in mid-trimester ultrasound fetal anomaly scan. In case of other fetal abnormalities are present the counceling by medical geneticist should be completed. In most cases complete spontaneous antenatal regresion of the lesion occur and the fetal surgery should be considered in adverse prognostic findings until 30 gestational weeks.
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Abstract
OBJECTIVES Pulmonary sequestration (PS) is a rare congenital malformation. This study presents the characteristics of PS in adult patients, including pulmonary function and concurrent infection, which have not been well documented previously. METHODS Patients ≥16 years old with a discharge diagnosis of PS from Peking Union Medical College Hospital between January 1990 and December 2013 were retrospectively analysed. Age, sex, clinical symptoms, chest computed tomography (CT) results, results of pulmonary function tests, diagnostic methods, type and localization of sequestration, origin of arterial supply, complications due to infection and treatment information were retrieved from hospital records and analysed. RESULTS Seventy-two patients were included in this study (mean age 36.6 ± 11.8 years). Clinical symptoms included cough, expectoration, haemoptysis, intermittent fever and chest pain. The most common CT findings were soft tissue opacity, cystic lesion, cavitary lesion and bronchiectasis. Intralobar and extralobar sequestrations were present in 92.8 and 7.2% of the patients, respectively. PS located in the left lower lobe was 2.1 times more frequent than that in the right lower lobe. PS was diagnosed by computed tomography angiography (CTA) in only 37.5% of patients; the remaining patients were undiagnosed before surgery. Obstructive ventilation dysfunction was found in 8.8% of patients. Pulmonary aspergillosis was detected in 9.7% of patients, and Pseudomonas aeruginosa was the leading pathogen (as determined by tissue cultures). PS was resected via thoracotomy in 87.0% of patients and via video-assisted thoracoscopic surgery (VATS) in 13.0%. CONCLUSIONS PS is a rare disease, and missed diagnosis and misdiagnosis are very common in PS patients. CTA and other angiography techniques should be used when there is suspicion of PS. Some PS patients have mild to moderate derangement of pulmonary ventilation, and PS might be associated with concurrent aspergillosis. VATS and posterolateral thoracotomy are both feasible methods for PS resection.
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Affiliation(s)
- Xuefeng Sun
- Department of Pulmonary Medicine, Peking Union Medical College Hospital, Beijing, China
| | - Yi Xiao
- Department of Pulmonary Medicine, Peking Union Medical College Hospital, Beijing, China
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25
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Doğan R, Dikmen E, Önder S. Intralobar pulmonary sequestration associated with congenital broncho-esophageal fistula. Turk J Pediatr 2015; 57:311-314. [PMID: 26701956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Pulmonary sequestration and congenital broncho-esophageal fistula are both rare malformations; nonetheless, in the presence of recurrent pulmonary infection, the possibility that one or the other may be involved should not be disregarded. To our knowledge, the concurrence of intralobar pulmonary sequestration and congenital broncho-esophageal fistula is very rare. Herein, we report a case of intralobar pulmonary sequestration combined with congenital broncho-esophageal fistula, both of which were successfully treated with surgery.
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Affiliation(s)
- Rıza Doğan
- Department of Thoracic Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
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26
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Abdelghani A, Ben Salem H, Benzarti W, Gargouri I, Garrouche A, Hayouni A, Benzarti M. Diagnosis of pulmonary sequestration: Contribution of the CT scan. Tunis Med 2015; 93:275-276. [PMID: 26375753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Abstract
A 50-year-old black man presented at the emergency department with midsternal, nonradiating chest pressure and chronic dyspnea on exertion. Four years before the current admission, he had been diagnosed with nonischemic cardiomyopathy at another facility. After our complete evaluation, we suspected that his symptoms arose from left-to-left shunting in association with pulmonary sequestration, a congenital malformation. Our preliminary diagnosis of secondary dilated cardiomyopathy was confirmed by normalization of the patient's ventricular size and function after lobectomy. To our knowledge, this patient is the oldest on record to present with cardiomyopathy consequent to pulmonary sequestration. His case is highly unusual because of his age and the rapid resolution of his symptoms after lobectomy. We believe that pulmonary sequestration should be included in the differential diagnosis of dilated cardiomyopathy.
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28
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Abstract
Pulmonary sequestration refers to segmental lung tissue that has no connection with the bronchial tree or pulmonary arteries. In adults, the clinical sequelae are usually related to infection. Patients are typically referred for sequestrectomy even when they are asymptomatic. There are no guidelines for treating patients who have pulmonary sequestration and coexisting cardiac valvular disease, in which case the venous drainage patterns of sequestra pose the additional risks of infective endocarditis and volume overload. We present the cases of 2 adult patients--one symptomatic and one asymptomatic--who had concurrent aortic valvular disease and pulmonary sequestration, and we discuss the factors involved in our evaluation of their cardiac risk and our treatment decisions. In view of the sparse data to predict cardiac risks, we think that pulmonary sequestrectomy in adult patients with concurrent valvular conditions should be considered on a case-by-case basis.
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29
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Gudavalli R, Farver CC, Mason DP, Hatipoglu U. Intralobar Pulmonary Sequestration Presenting as Chronic Non-productive Cough. Indian J Chest Dis Allied Sci 2015; 57:23-25. [PMID: 26410979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We report a case of a 60-year-old female who was known to have intralobar pulmonary sequestration and her only symptom was chronic cough. She had no history of infections and surgical resection led to complete resolution of her chronic cough.
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30
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Abstract
We report a case of bronchopulmonary sequestration (BPS) in a 60 year old man with recurrent cough. After failed antibiotic therapy for presumed left lower lobe (LLL) pneumonia seen on chest radiographs, bronchoscopy was performed revealing cryptogenic organizing pneumonia. Further work-up with thoracic imaging demonstrates a feeding artery from the thoracic aorta to the LLL consolidation indicating the presence of BPS. A brief review of the clinical and radiological features and management options of BPS are listed, with particular emphasis on the various imaging modalities and techniques in the diagnosis and pre-surgical planning of intralobar sequestration.
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Affiliation(s)
- Lena Naffaa
- Department of Radiology, Akron Children's Hospital, Akron, Ohio, USA
| | - Jay Tank
- Department of Radiology, Harlem Hospital, New York, New York, USA
| | - Sara Ali
- Department of Radiology, Harlem Hospital, New York, New York, USA
| | - Cesar Ong
- Department of Radiology, University of Minnesota Children's Hospital, Columbia, Missouri, USA
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31
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Haciibrahimoglu G, Aydogmus U, Bedirhan MA. Two concomitant congenital lung malformations mimicking a paravertebral mass. Asian Cardiovasc Thorac Ann 2014; 23:487-9. [PMID: 25009245 DOI: 10.1177/0218492314543502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We report the case of a 47-year-old woman who presented with the unique asymptomatic malformation of an extralobar pulmonary sequestration communicating with a bronchogenic cyst. Despite computed tomography and magnetic resonance imaging of the chest, the diagnosis could not be established before a left thoracotomy was performed. The sequestrated lobe and bronchogenic cyst were then successfully resected.
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Affiliation(s)
| | - Umit Aydogmus
- Thoracic Surgery Clinic, Yedikule Hospital for Chest Disease and Thoracic Surgery, Istanbul, Turkey
| | - Mehmet Ali Bedirhan
- Thoracic Surgery Clinic, Yedikule Hospital for Chest Disease and Thoracic Surgery, Istanbul, Turkey
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Chen YY, Huang TW, Chang H, Hsu HH, Lee SC. Intrathoracic caudate lobe of the liver: A case report and literature review. World J Gastroenterol 2014; 20:5147-5152. [PMID: 24803833 PMCID: PMC4009555 DOI: 10.3748/wjg.v20.i17.5147] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 02/09/2014] [Accepted: 03/05/2014] [Indexed: 02/06/2023] Open
Abstract
Heterotopic supradiaphragmatic livers are rare. A total of 23 cases of primary supradiaphragmatic livers have been reported in the literature. The clinical presentations of heterotopic supradiaphragmatic liver are variable. The simultaneous detection of intrathoracic accessory liver and pulmonary sequestration is extremely rare, and only one case has previously been reported. It is difficult to make a correct diagnosis preoperatively. We presented a 53-year-old woman with complaints of an intermittent, productive cough and dyspnea for two months that was refractory to medical treatment. She had no previous history of trauma or surgery. A chest radiograph only showed a widening of the mediastinum. Contrast-enhanced computed tomography of the chest revealed a well-circumscribed homogenous soft-tissue mass, approximately 4.35 cm × 2.5 cm × 6.14 cm in size, protruding through the right diaphragmatic crura to the right pleural cavity, attached to the inferior vena cava, esophagus and liver. There was no conclusive diagnosis before surgery. After the operation, we discovered that this patient was the first case of a supradiaphragmatic heterotopic liver, which passed through the inferior vena cava foramen and was coincidentally combined with an intralobar pulmonary sequestration that was found intraoperatively. We discussed its successful management with surgical resection via a thoracic approach and reviewed the published literature.
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Álvarez J A, Cleveland P C, Green M K, Sanhueza H E, Silva V J. [Transcatheter embolization device as a promising option in the treatment of pulmonary sequestration. Case reports]. Rev Chil Pediatr 2014; 85:197-202. [PMID: 25697208 DOI: 10.4067/s0370-41062014000200009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 01/27/2014] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Pulmonary sequestration (PS) has been treated for many years with conventional surgical removal of the ectopic lung tissue and ligation of aberrant vessels that arise from the aorta. There is evidence, especially in English-language literature that supports the use of transcatheter arterial embolization through a device for occlusion of the anomalous vessel, as a safe option and definitive treatment for intralobar PS. OBJECTIVE To show our experience pioneering the technique of PS treatment through transcatheter embolization. CASE REPORT The case reports of two teenagers aged 13 and 14 and a 26-day-old newborn that developed intralobar PS are described. The diagnosis was made through computerized axial tomography (CT scan) and successfully and without complication, during early and long term follow-up, treated by arterial embolization transcatheter. CONCLUSION The use of transcatheter arterial embolization is a less invasive and definitive treatment for patients with PS.
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Chojnacka H, Giżewska-Kacprzak K, Grodzki T, Rybkiewicz M, Nowakowski P, Gawrych E. Rare localization of an extralobar pulmonary sequestration in a child as a diagnostic challenge: a case report and review of the literature. Turk J Pediatr 2014; 56:203-207. [PMID: 24911860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We present a child with a rare finding of an extralobar pulmonary sequestration localized in the upper mediastinum. Findings of the prenatal screening enabled early postnatal diagnostic measures that revealed a heterogeneous mass situated next to the thymus. Based on the localization and inconclusive computed tomography images, the preoperative prediagnoses included enterogenic cyst, thymus cyst and teratoma. Intraoperative features of the vascular supply and structure of the mass drew the surgeons' suspicion to extralobar pulmonary sequestration, which was confirmed in the histopathological examination. The scans were reevaluated after the surgery. Surgical management was implemented prior to the occurrence of any symptoms, which led to a positive general outcome. The presented case should raise the awareness of radiologists, pediatric surgeons and other consultants involved in the diagnostic process of mediastinal lesions in children. The rare localization and lack of visualization of a systemic feeding artery can divert suspicion away from extralobar pulmonary sequestration in the preoperative differential diagnosis.
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Affiliation(s)
- Hanna Chojnacka
- Department of Pediatric and Oncological Surgery Pomeranian Medical University, Szczecin, Poland
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35
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Tamaki M, Yoshizawa K, Norimura S, Kenzaki K, Miura K. [Extralobar pulmonary sequestration mimicking posterior mediastinal tumor]. Kyobu Geka 2014; 67:135-138. [PMID: 24743484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The case was 13-year-old man. He visited local hospital due to high fever and back pain. He was diagnosed as acute pleuritis based on a chest computed tomography( CT) scan and referred to our hospital for treatment. Chest CT scan revealed a round shaped mass with clear margin at the left vertebrophrenic angle. A neurogenic posterior mediastinal tumor was suspected. Thoracoscopic surgery revealed that the mass had 2 thin string-like structures connecting to the descending aorta, and was suspected to be a pulmonary sequestration. The resected tumor was pathologically confirmed to be an extralobar pulmonary sequestration most of which was hemorrhagic necrosis caused by arterial infarction.
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Affiliation(s)
- Masafumi Tamaki
- Department of Chest Surgery, Takamatsu Red-cross Hospital, Takamatsu, Japan
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Lin X, Wu N, Shi Y, Wang S, Tan K, Dai H, Zhong J. Pulmonary sequestration with its feeding vessel originating from the proximal right coronary artery. Chin Med J (Engl) 2014; 127:1797. [PMID: 24791897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Affiliation(s)
- Xianru Lin
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health; Department of Cardiology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China
| | - Na Wu
- Department of Cardiology, Qingdao Municipal Hospital, Medical College, Qingdao University, Qingdao, Shandong 266011, China
| | - Yue Shi
- Department of Cardiology, Qingdao Municipal Hospital, Medical College, Qingdao University, Qingdao, Shandong 266011, China
| | - Shoudong Wang
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health; Department of Cardiology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China
| | - Kai Tan
- Department of Cardiology, Qingdao Municipal Hospital, Medical College, Qingdao University, Qingdao, Shandong 266011, China
| | - Hongyan Dai
- Department of Cardiology, Qingdao Municipal Hospital, Medical College, Qingdao University, Qingdao, Shandong 266011, China
| | - Jingquan Zhong
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health; Department of Cardiology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
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37
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Yan YN, Li JH, Wu QQ, Yao L, Wang XL, Zhan Y, Wang X. Fetal intrapericardial extralobar pulmonary sequestration. Chin Med J (Engl) 2013; 126:3999. [PMID: 24157178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Affiliation(s)
- Ya-ni Yan
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
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Delcour A, Peters JL, Lancellotti P. [Image of the month. Pulmonary sequestration]. Rev Med Liege 2013; 68:433-435. [PMID: 24180196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- A Delcour
- Service de Cardiologie, CHR Citadelle, Liege
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Lin CH, Chuang CY, Hsia JY, Lee MC, Shai SE, Yang SS, Hsu CP. Pulmonary sequestration-differences in diagnosis and treatment in a single institution. J Chin Med Assoc 2013; 76:385-9. [PMID: 23751815 DOI: 10.1016/j.jcma.2013.04.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 11/01/2012] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Pulmonary sequestration (PS) is a rare congenital lung malformation. In this study, we evaluated the diagnosis and treatment of PS in 31 adult patients at a single institution. METHODS A retrospective review of all patients 16 years of age and older with PS in a single institution between January 1985 and January 2011 was conducted. The following data were analyzed for all patients: major symptoms, diagnostic procedures, operative findings, operative techniques, postoperative complications, and outcome. RESULTS Our study involved 31 patients, 17 male and 14 female, with an average age of 32.1 (17-57) years, who underwent surgical intervention for PS. The preoperative symptoms of these patients included cough, hemoptysis, fever, pneumonia, and chest pain. Thirty (96.8%) patients were diagnosed by thoracic computed tomography. Of the 31 patients, 29 were diagnosed with intralobar pulmonary sequestration and two had extralobar pulmonary sequestration. Surgical procedures for intralobar pulmonary sequestration included lobectomy in 22 patients (including one thoracoscopic lobectomy), segmentectomy in six, and wedge resection in one of the patients. Thoracoscopic simple mass excision was performed on the two patients with extralobar pulmonary sequestration. Two patients had a postoperative complication (prolonged air leak in 1 patient and postoperative hemothorax in the other). The average hospital stay for all study patients was 6.4 (4-18) days, and there was no mortality. CONCLUSION Diagnostic tools may enable the clinician to obtain a definitive diagnosis in patients where there is a strong suspicion of PS via a noninvasive procedure. Computed tomography angiography may be the diagnostic imaging method of choice for optimal evaluation of the sequestrated lung and its vascular supply.
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Affiliation(s)
- Chih-Hung Lin
- Division of Thoracic Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
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Hamidian Jahromi A, Skweres J, Rao VR. A 33-year-old female with first episode of sudden onset massive hemoptysis. J La State Med Soc 2013; 165:209-211. [PMID: 24133783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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41
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Fontalba Navas M, Sánchez Gil J, Calvo Bonachera J. Bilateral pulmonary sequestration in an adult: case report and review of the literature. Arch Bronconeumol 2013; 49:410-1. [PMID: 23769316 DOI: 10.1016/j.arbres.2013.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 01/27/2013] [Accepted: 01/29/2013] [Indexed: 11/29/2022]
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42
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Falsini G, Porto I, Rosa I, Liistro F, Amidei S, Bolognese L. Bilateral intralobar pulmonary sequestrations receiving separate arterial supply from the right and circumflex coronary arteries: a case report. Int J Cardiol 2013; 166:e12-3. [PMID: 23398823 DOI: 10.1016/j.ijcard.2012.12.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 12/25/2012] [Indexed: 11/17/2022]
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Koh WJ, Hong G, Kim K, Ahn S, Han J. Pulmonary sequestration infected with nontuberculous mycobacteria: a report of two cases and literature review. ASIAN PAC J TROP MED 2013; 5:917-9. [PMID: 23146810 DOI: 10.1016/s1995-7645(12)60172-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2012] [Revised: 08/15/2012] [Accepted: 09/15/2012] [Indexed: 11/18/2022] Open
Abstract
We report two cases of pulmonary sequestration infected with nontuberculous mycobacteria (NTM): Mycobacterium avium and Mycobacterium abscessus. Chest computed tomography showed pneumonic consolidation in the right lower lobe, which received a systemic blood supply from the descending aorta in both patients. Video-assisted thoracoscopic surgeries were successfully performed and pathological examinations revealed multiple caseating granulomas. A review of the literature revealed only seven previous case reports of pulmonary sequestration infected with NTM, and no case with Mycobacterium abscessus has been reported.
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Affiliation(s)
- Won-Jung Koh
- Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, South Korea.
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Slancheva B, Hitrova S, Markov D, Vakrilova L, Pramatarova T, Yarukova N, Brankov O. [Congenital cystic lung lesions--review of the literature with three clinical cases]. Akush Ginekol (Sofiia) 2013; 52:26-32. [PMID: 23807978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Congenital cystic lung lesions are rare. Mainly affects the lower respiratory patishta.i are congenital cystic malformation and adematozna bronchopulmonary sequestration (BPS). The pathogenesis of the occurrence of these malformations is not clear but they have a common clinical course. In most cases, the anomaly is asymptomatic and occurs with infections of the lung during the first year of life. Currently congenital lung lesions were classified into five types and is considered by most authors. The anomaly is due to the abnormal proliferation of terminal bronchioles accompanied by inhibition of alveolar development between 7-17 weeks, obstructed airway dysplasia and metaplasia of normal lung tissue. Early diagnosis is vital in making a medical decision on how to treat CCAM. Associated with abnormalities of the urinary tract, cardiovascular system, gastrointestinal atresia, diaphragmatic hernia skeletal abnormalities. In pregnancies in which prenatal lung lesions weighs registered necessary series of ultrasound examinations to track finding and using the Doppler to assess how the blood supply of the fault. The clinical presentation of malformations is respiratory distress, respiratory infection, and dyspnea. The use of CT and MRA allows better visualization of the pulmonary lesions. With its combination with arteriography and bronchoscopy are used to differentiate CCAM and pulmonary sequestration. We present three cases with lung lesions were born in Neonatologia clinic at the University Hospital of Obstetrics and Gynecology "Maternity" Sofia for the period 2010-2012 three cases CCAMs type 1, operated by 5 meters after birth with a good final outcome without complications in the postoperative period and lack of pulmonary symptoms up to 1 year after birth.
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Debernardi DM, Bustos MEF, Alvarez Padilla F, Avalos S. [Lung malformation, intralobar pulmonary sequestration]. Rev Fac Cien Med Univ Nac Cordoba 2013; 70:94-95. [PMID: 24067594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
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Skrabski R, Royo Y, Di Crosta I, Pueyo C, Sempere T, Maldonado J. Extralobar pulmonary sequestration with an unusual venous drainage to the portal vein: preoperative diagnosis and excision by video-assisted thoracoscopy. J Pediatr Surg 2012; 47:e63-5. [PMID: 23084236 DOI: 10.1016/j.jpedsurg.2011.11.069] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2011] [Revised: 11/06/2011] [Accepted: 11/27/2011] [Indexed: 11/18/2022]
Abstract
Pulmonary sequestration is an uncommon congenital malformation of the lung that can be classified as intralobar or extralobar (ELS). Approximately 90% of ELS occur in the left hemithorax. Approximately 10% of ELS may present below the diaphragm. Both types of sequestrations are characterized by pulmonary tissue that does not communicate with the bronchial tree. The arterial blood supply to 80% ELS is through a direct branch of the thoracic or abdominal aorta, in 15% via another systemic artery and 5% from the pulmonary artery. The venous drainage of ELS is variable, predominantly into the systemic circulation (via the azygos vein, hemiazygos vein, or inferior vena cava). Approximately 25% drain completely or partially through the pulmonary veins. We report an extremely rare case of ELS with unusual venous drainage to the portal vein.
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Affiliation(s)
- Robert Skrabski
- Division of Pediatric Surgery, University Hospital of Joan XXIII, 43007 Tarragona, Spain.
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47
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Montjoy C, Hadique S, Graeber G, Ghamande S. Intralobar bronchopulmonary sequestra in adults over age 50: case series and review. W V Med J 2012; 108:8-13. [PMID: 23098004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Bronchopulmonary sequestration (BPS) is a rare congenital lung malformation, comprising only 0.15 to 6.4% of all cases of congenital lung malformation. It is characterized by an abnormal segment of bronchopulmonary tissue supplied by an aberrant systemic artery. Diagnostic delays are common in the adult patients since the symptoms often mimic other common diseases such as pneumonia, emphysema, and lung abscess. In 60% of cases, intralobar pulmonary sequestration (ILS) is typically diagnosed at age 20 or younger and is rarely found in adults older than 40 years. Since a heightened clinical suspicion needs to be maintained to entertain this diagnosis in the adult population, we conducted a retrospective chart review of all adult patients at our institution over age 50. MATERIALS AND METHODS A retrospective chart review of all adult patients evaluated at our institution with a pathological proven diagnosis of BPS and subsequent surgical correction from January 1993 through December 2008 was conducted. Data obtained included demographics, clinical presentation, diagnostic procedures, location and origin of the lesion, operative therapy, histology of the surgical specimen, and postoperative complications. RESULTS Three patients had undergone surgical correction for BPS. All three patients at our institution were female. The average age was 59 years with a range from 57 to 62 years. All three patients had symptoms preoperatively including intermittent cough and recurrent pneumonia. Radiologic evaluation revealed an enlarging lung mass in one patient and lesions suggestive of BPS in two of the patients. Two patients had a right lower lobe sequestration and one patient had a left lower lobe sequestration. All three patients underwent lower lobectomies without any significant postoperative complications. CONCLUSION BPS in patients older than 50 is very rare. Persistent lower lobe consolidation in medial or posterior basal segments accompanied by an aberrant artery in adults should heighten suspicion for it. Recurrent pneumonias, cough, chest pain occur in the majority of patients. Surgical excision after correctly identifying the aberrant vessel is curative and also diagnostic in some cases.
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Affiliation(s)
- Carol Montjoy
- Department of Radiology, West Virginia University Morgantown, WV, USA
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48
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Zhang ZQ, Lu H, Huang XM. [Perinatal diagnosis of pulmonary sequestration in a case]. Zhonghua Er Ke Za Zhi 2012; 50:392-393. [PMID: 22883045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Kheirandish R, Azizi S, Alidadi S. A case report of extralobar pulmonary sequestration in a dog. Asian Pac J Trop Biomed 2012; 2:333-5. [PMID: 23569925 PMCID: PMC3609297 DOI: 10.1016/s2221-1691(12)60034-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Revised: 11/20/2011] [Accepted: 12/04/2011] [Indexed: 01/28/2023] Open
Abstract
Pulmonary sequestration is a rare congenital anomaly in the veterinary literature. This malformation is characterized by a cystic mass of non-functioning primitive lung tissue that does not communicate with the tracheobronchial tree or with the pulmonary arteries. This article describes gross and histopathological characteristics of extralobar pulmonary sequestration in a dog. Grossly, a mass was observed in the left side of the thoracic cavity, closed to the caudal lobes of the lung, without communication with the tracheobronchial tree and the pulmonary arteries that was separated by pleural covering. Histopathologic examination showed emphysematous alveoli and bronchi, hypertrophy of smooth muscles and presence of the undifferentiated mesenchymal tissue. Therefore, based on microscopic findings, extralobar pulmonary sequestration was diagnosed. To the best of our knowledge, this is the first report of extralobar pulmonary sequestration in dog.
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Affiliation(s)
- Reza Kheirandish
- Department of Pathobiology, School of Veterinary Medicine, Shahid-Bahonar University of Kerman, Kerman, Iran
| | - Shahrzad Azizi
- Department of Pathology, School of Veterinary Medicine, Islamic Azad University, Shahrekord Branch, Shahrekord, Iran
| | - Soodeh Alidadi
- School of Veterinary Medicine, Shahid-Bahonar University of Kerman, Kerman, Iran
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Orsini B, Doddoli C, Brioude G, D'Journo XB, Trousse D, Gaubert JY, Thomas PA. [Non-tumoral vascular disorders of the lung in the adulthood]. Rev Pneumol Clin 2012; 68:146-151. [PMID: 22361065 DOI: 10.1016/j.pneumo.2012.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/19/2011] [Indexed: 05/31/2023]
Abstract
Non-tumoral vascular disorders of the lung are multiple, even if cases diagnosed in the adulthood are rare. They include congenital or acquired conditions, which related symptoms, if present, are non specific. This explains why their diagnosis is challenging and usually delayed. Surgery is the cornerstone of their treatment, although interventional radiology represents currently a less invasive alternative option for some of them.
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Affiliation(s)
- B Orsini
- Service de chirurgie thoracique et des maladies de l'œsophage, université de la Méditerranée, hôpital Nord, AP-HM, chemin des Bourrely, Marseille cedex 20, France
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