Intralobar pulmonary sequestration (a nonentity?)

Abstract

Intralobar pulmonary sequestration has generally been considered a congenital malformation in which an accessory lung bud develops, is enveloped by normal lung, and retains its systemic arterial supply. Also usually included in the "sequestration spectrum" are aberrant arteries to normal lung with either normal or anomalous venous connection. We reviewed all surgical pathology specimens and autopsies performed at Texas Children's Hospital from 1955 through 1984. There were 15 cases with an aberrant systemic artery to normal or abnormal lung. Nine were cases of structurally normal lung with an aberrant systemic artery, and five were cystic adenomatoid malformations with a systemic artery. In one older child some features of intralobar sequestration were present, but a major bronchial connection was retained. We propose that most intralobar sequestrations represent either cystic adenomatoid malformations that clinically are unrecognized until they become secondarily infected or developmentally normal lung supplied by a systemic artery.

Congenital cystic adenomatoid malformation: clinical features, pathological concepts and management in 172 cases

“…O fato de que alguns sequestros podem conter tecido idêntico à MACC enfatiza a lógica de combinar, e não separar, essas duas condições 15 . Em algumas séries de MACC, uma grande proporção, no mínimo 25%, tem suprimento arterial sistêmico associado 16 . Em nossa população, 34% dos pacientes apresentaram esse achado.…”

Pulmonary congenital cystic disease in adults. Spiral computed tomography findings with pathologic correlation and management

“…Occurrence of CAM associated with an ILS is rare, and only 41 cases of ILS-CAM located prevalently in the lower pulmonary lobes, have been reported [10, [37][38][39][40][41][42][43][44][45][46][47][48][49][50][51]. A large multicystic mass lesion is an uncommon presentation of ILS [36].…”

“…Sino ad oggi nella letteratura anglosassone sono stati riportati 41 casi di SP associata a MAC a localizzazione prevalentemente nei lobi inferiori [10, [37][38][39][40][41][42][43][44][45][46][47][48][49][50][51], come pure aspetti rari di SPI rappresentati da una voluminosa massa multicistica [36]. In realtà la diagnosi radiologica di SPI associato a lesione cistica uniloculare è possibile, ma l'origine delle cisti può essere stabilita solo con l'esame istologico.…”

Congenital masses of the lung: Changes in cross-sectional area during gestation

“…[9][10][11][12][13] In our study, half of the masses contained features of both type II CCAM and ILS. The reason for the preponderance of this lesion in our series is unknown but is likely related to the thorough analysis of the bronchial and vascular supplies of congenital lung masses performed by surgeons and pathologists at our hospital.…”

“…[14][15][16][17][18][19][20] Portions of these masses contain dilated bronchioles, alveolar ducts, and alveoli arranged in a normal acinar pattern that is typical of sequestration. 9 The arterial supply is from the thoracic or abdominal aorta, with multiple systemic arteries often supplying the masses. Other parts of the masses are composed of multiple small cysts, often arranged in a backto-back pattern characteristic of type II CCAM.…”