The Spectrum of Pulmonary Sequestration

Sade, Robert M.; Clouse, Melvin E.; Ellis, F. Henry

doi:10.1016/s0003-4975(10)64417-7

Cited by 210 publications

(95 citation statements)

References 43 publications

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“…PS are rare congenital anomalies -0.15%-6.4% of all congenital pulmonary malformations [2] -where a segment of pulmonary tissue has no developmental connection to the tracheobronchial tree or pulmonary arterial circulation. PS are divided according to their relationship with the pleura into intralobar and extralobar types.…”

Section: Discussionmentioning

confidence: 99%

Extralobar pulmonary sequestration diagnosed intraoperatively in a 37 year-old male with bullous lung disease

Tabbara

Jaoude

2015

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Pulmonary sequestration is a rare congenital abnormality. It is characterized by a mass of non-functioning, embryonic, cystic pulmonary tissue that receives its blood supply from the systemic circulation. The presentation is variable, ranging from no symptoms to hemoptysis. Herein, we present a case of an asymptomatic pulmonary sequestration incidentally diagnosed intra-operatively in a 37 year-old male with diffuse bullous lung disease.

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Section: Discussionmentioning

confidence: 99%

Extralobar pulmonary sequestration diagnosed intraoperatively in a 37 year-old male with bullous lung disease

Tabbara

Jaoude

2015

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“…However, modifications to this definition have been suggested by different authors to incorporate a wider spectrum of abnormalities. The ''sequestration spectrum'' includes various combinations of abnormal bronchial connection, arterial supply and venous drainage under the same spectrum [5]. Anomalous systemic arterial supply to normal segments of the lung has been classified as Pryce Type I sequestration [6].…”

Section: Discussionmentioning

confidence: 99%

Dual arterial supply to normal lung: within the sequestration spectrum

Irodi¹,

Cherian²,

Keshava³

et al. 2010

BJR

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ABSTRACT. We report a rare case of dual arterial supply to an otherwise normal left lower lobe. In addition to normal pulmonary arterial supply, the lower lobe of the left lung also received systemic arterial supply from the coeliac axis. The relevant anatomy and literature are reviewed. To the best of our knowledge, there are no other reported cases of anomalous systemic arterial supply from the coeliac axis to the basal segments of the left lower lobe with normal bronchial branching and pulmonary arterial supply. Systemic arterial supply to the lungs can be congenital or acquired. In the commonly reported congenital form of systemic arterial supply to the basal segments of the left lower lobe, there is abrupt tapering of the left lower lobar pulmonary artery distal to the origin of the superior segmental artery and the aberrant systemic artery originates from the descending thoracic aorta [1,2]. We report a rare case of dual arterial supply from the pulmonary and systemic arteries to the basal segments of the left lower lobe with a normal bronchial tree. Case reportA 47-year-old woman presented with history of occasional blood-streaked sputum for the past 9 years. There was no history of excessive sputum production or past history of tuberculosis. Clinical examination was unremarkable, as were routine laboratory investigations.The chest radiograph showed a few linear opacities in the left retrocardiac region (Figure 1). Bronchoscopy was normal. High-resolution computed tomography (HRCT) of the thorax was carried out to look for underlying bronchiectasis as the cause of haemoptysis. HRCT revealed a few asymmetrical dilated vessels in the left lower lobe; there was minimal adjacent ground-glass opacity and few linear opacities, suggesting postinflammatory changes (Figure 2). In view of the presence of dilated vessels, a vascular malformation was suspected and CT angiography was performed. The CT angiogram showed aberrant systemic arterial supply to the basal segments of the left lower lobe; this arterial supply arose from the coeliac axis. This anomalous artery entered the thorax via the oesophageal hiatus, traversed parallel and to the left of the oesophagus and entered the left lower lobe via the pulmonary ligament, supplying the basal segments. There was no arteriovenous malformation. Pulmonary arterial supply to the left lower lobe was also present with normal arborisation. Although the descending pulmonary artery appeared slightly smaller than on the right side, all the basal segmental branches were identified. The normal pattern of venous drainage into the inferior pulmonary vein was seen. The lung parenchyma showed mild linear and ground-glass opacity with normal branching of the bronchial tree (Figures 3, 4, 5, 6, 7 and 8). The patient was not keen on surgery or endovascular treatment and is on follow-up.

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“…3 Thirty percent of ELS occur in association with Bochdalek hernias. 7 Increasingly, ELS are being discovered by in utero sonography. A significant number (35 to 70%) of inutero detected ELS spontaneously regress during pregnancy.…”

Section: Denouement and Discussionmentioning

confidence: 99%