Mediastinal Lung Herniation Associated With Pulmonary Sequestration

Fujisawa, Hidefumi; Tanaka, Eriko; Kushihashi, Tamio; Baba, Maiko; Usui, Nobutaka; Ukisu, Ryutaro; Takenaka, Hiroyuki; Kamio, Yoshito; Kitami, Akihiko; Nakajima, Hiroaki; Shiokawa, Akira

doi:10.1097/rti.0b013e31805ba392

Cited by 7 publications

(14 citation statements)

References 14 publications

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“…Intervening pleural layers should not be seen on high-resolution, thin-slice CT imaging. 13 In summary, we have described an adult patient presenting with a combination of horseshoe lung, pulmonary artery sling, complete bowel malrotation, and renal ectopia. This report emphasizes the importance of searching for additional anomalies when horseshoe lung is detected.…”

Section: Discussionmentioning

confidence: 96%

A Rare Case of Horseshoe Lung Presenting in Adulthood and Associated With a Pulmonary Sling

McDonald

Hartman²

2010

Journal of Thoracic Imaging

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Horseshoe lung is a rare congenital malformation in which the pulmonary parenchyma connects in the midline posterior to the pericardium and anterior to the aorta and esophagus. There have been 51 case reports in the world literature. About 80% of these have been associated with Scimitar syndrome, and most cases are diagnosed in infancy due to pulmonary symptoms. To our knowledge, this is the first case report of horseshoe lung presenting in an adult and associated with a pulmonary sling, complete bowel malrotation, and renal ectopia.

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Section: Discussionmentioning

confidence: 96%

A Rare Case of Horseshoe Lung Presenting in Adulthood and Associated With a Pulmonary Sling

McDonald

Hartman²

2010

Journal of Thoracic Imaging

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“…In our case, chest radiography revealed a hypolucent left lung and mediastinal deviation to the left ( Figure 1 ). Mediastinal lung herniation associated with agenesis of the left lung was considered as a differential diagnosis [ 17 ]. The pathology of unilateral pulmonary agenesis and hypoplasia has been categorized by Schneider and Schwalbe [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Our patient was diagnosed with HL involving left lung hypoplasia because the patient’s left pulmonary artery and vein were clearly identified by 128-slice DSCT ( Figure 3 ). In cases of mediastinal lung herniation, the visceral pleura is located between the herniated and contralateral lungs [ 17 ]. In our case, no fissure was detected between the isthmus of lung parenchymal tissue and the left lung on CT images, which was also compatible with HL.…”

Section: Discussionmentioning

confidence: 99%

Horseshoe Lung Associated with Left Lung Hypoplasia: Case Report and Systematic Review of the Literature

et al. 2015

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SummaryHorseshoe lung (HL) is often associated with cardiovascular malformations such as scimitar syndrome and unilateral lung hypoplasia. In patients with HL, the hypoplastic lung is almost always located on the right side. Cases of HL with a hypoplastic left lung are extremely rare.In this paper, we describe a case of a one-day-old boy with HL involving left lung hypoplasia and perform a systematic review of the literature on HL with left lung hypoplasia.Only 10 cases of HL involving left lung hypoplasia have been reported in the literature. Most of those cases also exhibited cardiovascular malformations and pulmonary hypertension. There have not been any reported cases of HL involving left lung hypoplasia associated with scimitar syndrome.HL involving left lung hypoplasia is rare and tends to be associated with pulmonary hypertension.

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“…As ILS is defined as being enveloped within the lobe of the normal lung, ILS protruding into the posterior mediastinum is extremely rare. To the best of our knowledge, only one case of mediastinal herniation associated with ILS has been reported by Fujisawa et al [ 2 ]. In that report, the site through which the mass protruded into the mediastinum was not described.…”

Section: Case Presentationmentioning

confidence: 99%

“…As ILS consists of a portion of normal lung tissue, it is rarely reported to expand into the mediastinum and further to the opposite side of the chest. Indeed, there has been only one previous report of mediastinal herniation associated with ILS [ 2 ] to date. Herein, we report two extremely rare cases of infants with ILS expanded toward the posterior mediastinum and contralateral thorax.…”

Section: Introductionmentioning

confidence: 99%

Intralobar pulmonary sequestration expanding toward the contralateral thorax: two case reports

Amano¹,

Fujishiro²,

Hinoki³

et al. 2017

BMC Surg

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BackgroundIntralobar pulmonary sequestration (ILS) is defined as a portion of parenchyma that is contained within the normal pleural investment of the lung but not connected to the tracheobronchial tree, and supplied by anomalous systemic arteries. As ILS is enveloped within the lobe of the normal lung, it is extremely rare for ILS to invade into the mediastinum. We report two atypical cases of infants with ILS expanded toward the posterior mediastinum and contralateral thorax through the pulmonary ligament.Case presentationThe first case involved a baby boy diagnosed at 30 weeks gestation with a cystic area in his right lower lobe. A chest computed tomography (CT) scan at 29 days of life showed low-density masses in the right lower lung and posterior mediastinum. A complete thoracoscopic right lower lobectomy was performed at 19 months of age. After ligation of the aberrant systemic artery, the mediastinal mass was pulled into the right pleural cavity. The mass was observed to connect to the right lower lobe mass as a segment of lung parenchyma situated within the normal pleural investment of the lung, and the patient was diagnosed with ILS. The second case involved the detection by chest CT of a left lower lung cystic mass that protruded into the posterior mediastinum and contralateral chest of a one-month-old baby girl. A complete thoracoscopic left lower lobectomy was performed at the age of 18 months, and the cystic mass located in the right thoracic cavity was pulled easily into the left pleural cavity and resected. An anomalous systemic artery was identified and ligated, and the patient was also diagnosed with ILS.ConclusionsAs the pulmonary ligament consists of two layers of mediastinal pleura, lower lung ILS with its visceral pleura covering can, though rarely, protrude into the mediastinum through the pulmonary ligament. Our two extremely rare cases of infants with ILS expanded toward the posterior mediastinum and contralateral thorax were successfully treated using a unilateral thoracoscopic approach. Pre-surgical differential diagnosis of mediastinal masses using contrast-enhanced multiple detector CT is important in informing the appropriate surgical approach.

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Mediastinal Lung Herniation Associated With Pulmonary Sequestration

Cited by 7 publications

References 14 publications

A Rare Case of Horseshoe Lung Presenting in Adulthood and Associated With a Pulmonary Sling

A Rare Case of Horseshoe Lung Presenting in Adulthood and Associated With a Pulmonary Sling

Horseshoe Lung Associated with Left Lung Hypoplasia: Case Report and Systematic Review of the Literature

Intralobar pulmonary sequestration expanding toward the contralateral thorax: two case reports

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