Pulmonary sequestration: A single-institutional series composed of 27 cases

Abstract

Owing to the potentially severe complications they can cause, pulmonary sequestrations should be removed whenever they are diagnosed. Since careful dissection provides sufficient surgical comfort, preoperative identification of the aberrant vessels is not a rule for the success of the operation.

Malformações pulmonares congênitas

“…Pulmonary sequestration accounts for 0.15-6.45% of all lung malformations (9)(10)(11)(12)(13)(14) and is characterized by normal, nonfunctioning lung tissue that has no connection with the bronchial tree and receives its blood supply from the systemic circulation. (4,10,(12)(13)(14) Pulmonary sequestrations can be classified as extralobar or intralobar depending on their location in relation to the adjacent normal lung and on their visceral pleural covering.…”

“…(4,10,(12)(13)(14) Pulmonary sequestrations can be classified as extralobar or intralobar depending on their location in relation to the adjacent normal lung and on their visceral pleural covering. (4,10,11,15) There is a third, rarer, extralobar pulmonary sequestration is composed of irregular bronchi and bronchioles, as well as by alveoli that are twice to five times their normal size. (18) Dilated lymphatic vessels in the subpleural region are found in 85% of cases.…”

“…(5) is covered by visceral pleura and separated from the functioning lung, whereas intralobar pulmonary sequestration can be completely covered by normal lung tissue or by a segment of the visceral pleura of the lung lobe within which the sequestration occurs. (11)(12)(13)(14) Pulmonary sequestrations are responsible for 1.1-1.8% of all pulmonary resections. (14) In rare cases, the extralobar and intralobar forms can occur simultaneously.…”

“…Although there is a consensus that the extralobar form is congenital, it is still debated whether the intralobar form is congenital or acquired. (11) There is a theory that intralobar pulmonary sequestration is either congenital, arising from a lung bud that originates in the foregut, or a result of a sequence of events, including bronchial obstruction, pneumonia, local pleurisy, and parasitization of pulmonary ligament arteries. (17) No chromosomal abnormalities have been associated with pulmonary sequestration.…”

“…(10,15,18) Extralobar pulmonary sequestrations are generally located in the lower lobes of the left lung (80%), (4,13,15,19) in close proximity to the costophrenic sulcus (Figure 1), and are less common than are intralobar pulmonary sequestrations, which account for approximately 75% of all cases of pulmonary sequestrations. (9)(10)(11)13,15,18,20) Approximately 10% of all extralobar pulmonary sequestrations are located below the diaphragm. (18) In intralobar pulmonary sequestrations, there is no lung segment predominance (10) ; however, some authors have reported a greater frequency of intralobar pulmonary sequestrations in the posterior basal segment of the left lower lobe.…”