Lung sequestration: report of seven cases and review of 540 published cases

Savić, Bojana; Birtel, F. J.; Tholen, W; Funke, Harald; Knoche, R

doi:10.1136/thx.34.1.96

Cited by 631 publications

(507 citation statements)

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“…In ILS, causes of cystic lesions include bronchiectasis and cystic adenomatoid malformation, which can be unicystic or polycystic. 5 In this patient, the cystic lesions were related to a cystic adenomatoid malformation and were intermediate between type 1, in which the cysts are greater than 3 cm, and type 2 in which the cysts vary between 0.5 and 3.0 cm. 8 The presence of cystic adenomatoid malformation within ILS is also usually type 2.…”

Section: Denouement and Discussionmentioning

confidence: 66%

“…6 The pulmonary venous drainage is predominantly to the left atrium in 95% of cases. 5 If the drainage is to the system veins (4.25% of cases), it occurs primarily to the inferior vena cava and to the azygos vein, as in this patient. Communication with the esophagus occurs in some sequestrations and creates a distinctive and rare lesion and a very complex type of bronchopulmonary foregut malformation.…”

Section: Denouement and Discussionmentioning

confidence: 84%

“…1 The arterial supply is from systemic arteries, 74% directly from the thoracic aorta, 12% from the abdominal aorta and the remainder from other arteries such as the subclavian artery. 5 The aortic vessel is usually large, varying in size from 1 mm to 1.5 cm in diameter. Atherosclerotic changes are common in the anomalous artery in ILS, even in young patients.…”

Section: Denouement and Discussionmentioning

confidence: 99%

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Congenital intralobar pulmonary sequestration with cystic adenomatoid malformation

Herman

Siegel

2009

J Perinatol

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Case presentation A 3000 g infant was born at 39 weeks gestation to a gravida 2, para 2 mother after a pregnancy complicated by an abnormal fetal sonogram that was reported to demonstrate a large cystic thoracic mass. The baby was delivered by elective repeat C-section and had Apgar scores of 8 at 1 min and 9 at 5 min. The infant was not in distress. An initial plain chest radiograph (Figure 1), abdominalthoracic sonogram ( Figure 2) and a multidetector chest computed tomography (CT) and CT angiogram ( Figure 3) were then performed. Denouement and discussionThe chest radiograph shows subtle lucency in the left lower lobe and hyperexpanded left lung. The sonogram showed an echogenic mass with feeding artery. CT confirmed the presence of an intrapulmonary, hypervascular cystic and solid mass in the medial posterior left lower lobe. The lesion receives arterial blood supply from an anomalous vessel directly arising from the thoracic aorta and has drainage through an anomalous vein into the azygos vein. The air-filled cystic component of the lesion is peripherally located and at the interface with the more normal lung. The remainder of the lesion is not aerated, but is surrounded by normally aerated left lower lobe, medially, laterally and superiorly. Because of the risk of infection and malignant degeneration, which is associated with the presumed cystic adenomatoid elements in this lesion, the lesion was resected. Surgical resection demonstrated a cystic and solid mass in the left lower lobe with blood supply from a 1-cm diameter artery arising directly from the thoracic aorta with venous drainage into the azygos vein. This complex mass was within the left lower lobe and within the visceral pleural. Pathological examination of the specimen confirmed a sequestration and associated congenital cystic adenomatoid malformation with intermediate-type cysts between types 1 and 2.Intralobar sequestration (ILS) refers to nonfunctioning lung tissue with anomalous arterial supply from the aorta, venous

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Section: Denouement and Discussionmentioning

confidence: 66%

Section: Denouement and Discussionmentioning

confidence: 84%

Section: Denouement and Discussionmentioning

confidence: 99%

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Congenital intralobar pulmonary sequestration with cystic adenomatoid malformation

Herman

Siegel

2009

J Perinatol

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“…A drenagem venosa se faz habitualmente pelas veias pulmonares, ou, menos freqüente-mente, pelo sistema hemiázigos 1,4 . Em cerca de 90% das vezes a SPI se apresenta como achado isolado, desacompanhado de outras alterações ecográficas 1,[3][4][5][6][7] .…”

Section: Introductionunclassified

Diagnóstico pré-natal de seqüestração pulmonar: apresentação de um caso

Nicola¹,

Frigério²,

Filho³

et al. 2003

Rev. Bras. Ginecol. Obstet.

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IntroduçãoA seqüestração pulmonar (SP) é massa de tecido pulmonar anormal que usualmente não mantém comunicação com a árvore traqueobrônquica e cujo suprimento sangüíneo é proveniente de arté-ria anômala derivada da circulação sistêmica 1.2 .A sua etiologia não é consensual. Há duas hipóteses mais prováveis 1,3 : formação e migração caudal de broto pulmonar supranumerário que acompanha o esôfago, ou deficiência vascular pulmonar primária justificando a persistência de circulação colateral sistêmica. A primeira explicaria a notória preferência pela localização no hemitórax esquerdo e, mais freqüentemente, no seu terço inferior. Já a segunda justificaria a persistência de suprimento sangüíneo anômalo.Existem duas formas de seqüestração broncopulmonar: a intralobar (SPI) e a extralobar (SPE). A SPI é mais encontrada em crianças, representando 70% dos casos nesta faixa etária, notando-se discreDiagnóstico Pré-natal de Seqüestração Pulmonar:Apresentação de um Caso PALAVRAS-CHAVE: Seqüestração broncopulmonar. Malformações fetais. Dopplervelocimetria.to predomínio em meninos (1,5 para 1) 4 . Caracteriza-se por compartilhar o mesmo revestimento pleural visceral do pulmão normal. Sua localização mais freqüente é o segmento póstero-lateral do lobo inferior esquerdo. Seu aporte sanguíneo deriva-se em 75% dos casos da artéria aorta e, nos outros 25% dos casos, de outros vasos torácicos ou abdominais 1,4 . A drenagem venosa se faz habitualmente pelas veias pulmonares, ou, menos freqüente-mente, pelo sistema hemiázigos 1,4 . Em cerca de 90% das vezes a SPI se apresenta como achado isolado, desacompanhado de outras alterações ecográficas 1,[3][4][5][6][7] .A SPE é mais comum em fetos e neonatos, notando-se também predomínio maior em meninos (3 para 1) 4 . Caracteriza-se por possuir revestimento pleural independente do pulmão normal. O seu suporte vascular provém na maior parte das vezes da aorta ou de um dos seus ramos e a sua drenagem venosa pode ser feita pelos sistemas ázigos, hemiázigos, porta ou pelas veias pulmonares 4 . Sua localização mais comum é a parte posterior do tórax 1,4 . Em 80 a 90% dos casos encontra-se à esquerda 1,4 . Em até 15% das vezes pode situar-se em topografia subdiafragmática, devendo sempre ser lembrada como diagnóstico diferencial das massas abdominais 4 . Há relatos na literatura de topografias mediastinal, retroperitoneal

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“…[15][16][17] A number of associated anomalies, often severe, have been reported in approximately two-thirds of ELS cases. 3,18,19 These include CCAM, gastrointestinal abnormalities, and diaphragmatic hernia. CCAM-like features were noted in this case.…”

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confidence: 99%

Subdiaphragmatic Pulmonary Sequestration: A Case Report With Review of the Literature

et al. 2000

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Pulmonary sequestration is defined as a mass of abnormal lung tissue that does not communicate with the tracheobronchial tree through a normally located bronchus. Most authors classify these sequestrations either as extralobar if the mass is covered by its own pleural investment or intralobar if incorporated within the normal lung without a separate pleural membrane. Sequestrations may communicate with the gastrointestinal tract 1 and are also supplied by an anomalous systemic artery. The vast majority of the extralobar lesions are present within the thorax, most frequently between the left lower lobe and the diaphragm and rarely below it. 2 Embryologically, these lesions are best categorized as a form of foregut malformation. 1,3,4 Associated anomalies are seen in ϳ65% of the patients with extralobar sequestrations (ELS) and rarely in patients with intralobar sequestrations. The anomalies usually include diaphragmatic hernias and congenital cystic adenomatoid malformation (CCAM).Bronchogenic cysts, teratomas, neuroblastoma, intestinal duplications cysts, adrenal hemorrhage, and renal dysplasia should be considered among the more common differential diagnoses of subdiaphragmatic lesions in the perinatal period. CLINICAL HISTORYA left suprarenal mass was detected at 22 weeks' gestation during a routine ultrasound (US). A 1.5 ϫ 0.8-cm hyperechoic and cystic lesion was noted to the left of the lumbar spine and superior to the left kidney (Figure 1). No feeding vessel was noted by US, and no hemorrhage was detected by ultrafast fetal magnetic resonance imaging. The clinical differential diagnosis included neuroblastoma and pulmonary sequestration. The postnatal computed tomography scan and US were consistent with an adrenal neuroblastoma. Neonatal urinary vanilylmandelic acid was reported as negative.The left adrenal and the tumor were resected at 40 days after delivery. The specimen weighed 3.56 gm and contained a 2 ϫ 1 ϫ 0.5-cm "fleshy" nodule along the superior and medial aspect of the adrenal gland. Serial longitudinal sections disclosed a well-delineated, solid, tan lesion with a 0.2-cm white-gray collapsed cyst at one of the edges (Figure 2). The adjacent adrenal gland was unremarkable.Touch preparations disclosed many ciliated columnar cells (Figure 3). The nodule was composed of many irregular cystic and tubular structures resembling bronchioles. These structures were lined by a ciliated respiratory epithelium and were surrounded by smooth muscle fibers and islands of cartilage resembling a CCAM type II ( Figure 4). In other areas, the lesion had an alveolar pattern, and the luminal spaces contained proteinaceous fluid with many foamy macrophages. There was an associated mild lymphocytic infiltrate. The adjacent adrenal gland was normal for age. DISCUSSIONELS located in the abdomen are rarely diagnosed before excision. Certain laboratory and imaging pitfalls should be considered to avoid a misdiagnosis. [5][6][7][8][9][10][11][12][13][14][15] For example, vanilylmandelic acid and homovanillic acid may be ne...

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Lung sequestration: report of seven cases and review of 540 published cases

Cited by 631 publications

References 3 publications

Congenital intralobar pulmonary sequestration with cystic adenomatoid malformation

Congenital intralobar pulmonary sequestration with cystic adenomatoid malformation

Diagnóstico pré-natal de seqüestração pulmonar: apresentação de um caso

Subdiaphragmatic Pulmonary Sequestration: A Case Report With Review of the Literature

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