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Marwah V, Katoch C, Jhamb D, Bhattacharjee S, Choudhary R. A very rare case of lingular sequestration. Med J Armed Forces India 2023; 79:235-237. [PMID: 36969111 PMCID: PMC10037044 DOI: 10.1016/j.mjafi.2020.03.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 03/27/2020] [Indexed: 11/20/2022] Open
Abstract
Pulmonary sequestration also called as bronchopulmonary sequestration is a rare congenital anomaly. It is defined as a mass of dysplastic lung tissue which has no connection with the main bronchopulmonary tree and is supplied by a branch of systemic artery and drainage by the separate venous system. It can be classified into intralobar and extralobar variety, with intralobar being more common. Its incidence is around 1 per 8300 to 35000, and it constitutes about 0.15-6.4% of all congenital lung anomalies. It generally involves lower lobes with the left lobe being more common than the right. It is an uncommon entity and rarely reported in literature for lingula. Its distribution is equal in gender distribution except for extralobar variety which has a male preponderance. It generally presents with recurrent pneumonia and hemoptysis. Here, we describe a very rare case of intralobar lingular sequestration in a patient who presented with recurrent chest infections and was managed with segmentectomy.
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Affiliation(s)
- Vikas Marwah
- Senior Adviser (Resp Med) and Pulmonary Critical Care & Sleep Medicine, AICTS, Pune 411040, India
| | - C.D.S. Katoch
- Professor & Head (Pulmonary Medicine), Critical Care and Sleep Medicine, AICTS, Pune 411040, India
| | - Dhiraj Jhamb
- Senior Adviser, (Surgery and CT Surgery), AICTS, Pune 411040, India
| | | | - Robin Choudhary
- Resident (Pulmonary Medicine), Critical Care and Sleep Medicine, AICTS, Pune 411040, India
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2
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Gabelloni M, Faggioni L, Accogli S, Aringhieri G, Neri E. Pulmonary sequestration: What the radiologist should know. Clin Imaging 2020; 73:61-72. [PMID: 33310586 DOI: 10.1016/j.clinimag.2020.11.040] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 11/13/2020] [Accepted: 11/24/2020] [Indexed: 12/11/2022]
Abstract
Pulmonary sequestration consists of a nonfunctioning mass of lung tissue, either sharing the pleural envelope of the normal lung (intralobar) or with its own pleura (extralobar), lacking normal communication with the tracheobronchial tree and receiving its arterial supply by one or more systemic vessels. It is the second most common congenital lung anomaly according to pediatric case series, but its real prevalence is likely to be underestimated, and imaging plays a key role in the diagnosis and treatment management of the condition and its potential complications. We will give a brief overview of the pathophysiology, clinical presentation and imaging findings of intra- and extralobar pulmonary sequestration, with particular reference to multidetector computed tomography as part of a powerful and streamlined diagnostic approach.
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Affiliation(s)
- Michela Gabelloni
- Diagnostic and Interventional Radiology, Department of Translational Research, University of Pisa, Via Roma, 67, 56126 Pisa, Italy
| | - Lorenzo Faggioni
- Diagnostic and Interventional Radiology, Department of Translational Research, University of Pisa, Via Roma, 67, 56126 Pisa, Italy.
| | - Sandra Accogli
- Diagnostic and Interventional Radiology, Department of Translational Research, University of Pisa, Via Roma, 67, 56126 Pisa, Italy
| | - Giacomo Aringhieri
- Diagnostic and Interventional Radiology, Department of Translational Research, University of Pisa, Via Roma, 67, 56126 Pisa, Italy
| | - Emanuele Neri
- Diagnostic and Interventional Radiology, Department of Translational Research, University of Pisa, Via Roma, 67, 56126 Pisa, Italy
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Sadeghpour A, Firouzi A, Pouraliakbar H, Ghadrdoost B, Behjati M. Dilated cardiomyopathy as a rare presentation of the pulmonary sequestration: A case report with aberrant vessel from aorta to left lower pulmonary lobe. J Cardiol Cases 2019; 20:49-51. [PMID: 31440311 DOI: 10.1016/j.jccase.2019.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/19/2019] [Accepted: 03/22/2019] [Indexed: 10/26/2022] Open
Abstract
Late onset non-ischemic cardiomyopathy is a rare manifestation of the presence of aberrant vessel from descending thoracic aorta to left lower lobe of lung. This congenital anomaly is associated with pulmonary sequestration. Our case was a 23-year-old male who was under observation since the age of 19 years for evaluation of shortness of breath, functional class II. He had history of professional athletic training and he denied consumption of any compound. Ejection fraction had deteriorated during three years from 45-50% to 40% and left ventricular size increased from normal size to mild enlargement. Cardiac computed tomography showed presence of aberrant artery from descending aorta to left lower pulmonary lobe with pulmonary sequestration. His cardiac function improved after successful coil embolization of aberrant vessel. In conclusion, pulmonary sequestration and aberrant pulmonary supply from aorta should be considered as a rare cause of dilated cardiomyopathy which can be reversible by proper intervention. <Learning objective: Aberrant pulmonary supply from aorta could be considered in cases with dilated cardiomyopathy. Since this disease entity is reversible, earlier diagnosis is essential.>.
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Affiliation(s)
- Anita Sadeghpour
- Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ata Firouzi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Pouraliakbar
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Behshid Ghadrdoost
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohaddeseh Behjati
- Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
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4
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Galego MA, Pereira N, Guimarães S, Amado J, Silva AC. Ischaemic Heart Disease Induced by Intralobar Pulmonary Sequestration. Arch Bronconeumol 2019; 55:547-549. [PMID: 31230845 DOI: 10.1016/j.arbres.2019.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 02/25/2019] [Accepted: 03/11/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Maria Antónia Galego
- Department of Pulmonology, Unidade Local de Saúde de Matosinhos E.P.E., Matosinhos, Portugal.
| | - Nídia Pereira
- Department of Internal Medicine, Unidade Local de Saúde de Matosinhos E.P.E., Matosinhos, Portugal
| | - Susana Guimarães
- Department of Anatomical Pathology, Centro Hospitalar de São João E.P.E., Porto, Portugal
| | - Joana Amado
- Department of Pulmonology, Unidade Local de Saúde de Matosinhos E.P.E., Matosinhos, Portugal
| | - Ana Catarina Silva
- Department of Radiology, Unidade Local de Saúde de Matosinhos E.P.E., Matosinhos, Portugal
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Jelin EB, O'Hare EM, Jancelewicz T, Nasr I, Boss E, Rhee DS. Optimal timing for elective resection of asymptomatic congenital pulmonary airway malformations. J Pediatr Surg 2018. [PMID: 29514740 DOI: 10.1016/j.jpedsurg.2018.02.032] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE We sought to determine optimal timing for CPAM resection within the first year of life. METHODS We queried the National Surgical Quality Improvement Program pediatric database from 2012 to 2015 for elective CPAM resections on patients less than 1year of age. Patients were divided by age in months: 1-3 (n=57), 4-6 (n=135), and 6-12 (n=214). Patient operative variables and 30-day postoperative outcomes were compared. RESULTS A total of 406 patients were included with no differences in demographics or comorbidities. Median operative time increased with each older age category (115min, 152min, 163min, respectively; p<0.01). Thoracoscopic approach was less utilized in 1-3months (40.4%) compared to the older two age categories (65.9% and 69.6%, respectively; p<0.01). There were no differences by age in major complications, conversion to open, or readmissions. On multivariate analysis, ASA class≥3 (p<0.01) and prolonged operative time (p<0.01) were associated with a major complication. Furthermore, operations on patients aged 6-12months were associated with increased operative time (p<0.01) regardless of operative approach. CONCLUSION Elective CPAM resections are equally safe in patients 1-12months of age. Earlier resection including both open and thoracoscopic resection is associated with decreased operative time. LEVEL OF EVIDENCE IIc, Outcomes Research.
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Affiliation(s)
- Eric B Jelin
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
| | - Elizabeth M O'Hare
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Tim Jancelewicz
- Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Isam Nasr
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Emily Boss
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Daniel S Rhee
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Rao DS, Barik R. Rare presentation of intralobar pulmonary sequestration associated with repeated episodes of ventricular tachycardia. World J Cardiol 2016; 8:432-435. [PMID: 27468336 PMCID: PMC4958694 DOI: 10.4330/wjc.v8.i7.432] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 05/02/2016] [Accepted: 06/02/2016] [Indexed: 02/06/2023] Open
Abstract
Arterial supply of an intralobar pulmonary sequestration (IPS) from the coronary circulation is extremely rare. A significant coronary steal does not occur because of dual or triple sources of blood supply to sequestrated lung tissue. We present a 60-year-old woman who presented to us with repeated episodes of monomorphic ventricular tachycardia (VT) in last 3 mo. Radio frequency ablation was ineffective. On evaluation, she had right lower lobe IPS with dual arterial blood supply, i.e., right pulmonary artery and the systemic arterial supply from the right coronary artery (RCA). Stress myocardial perfusion scan revealed significant inducible ischemia in the RCA territory. Coronary angiogram revealed critical stenosis of proximal RCA just after the origin of the systemic artery supplying IPS. The critical stenosis in the RCA was stented. At 12 mo follow-up, she had no further episodes of VT or angina.
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Fievet L, Natale C, D'Journo XB, Coze S, Dubus JC, Guys JM, Thomas P, De Lagausie P. Congenital pulmonary airway malformation and sequestration: Two standpoints for a single condition. J Minim Access Surg 2015; 11:129-33. [PMID: 25883453 PMCID: PMC4392486 DOI: 10.4103/0972-9941.137759] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Accepted: 02/23/2014] [Indexed: 11/17/2022] Open
Abstract
In adults, congenital pulmonary malformations are candidates for surgery due to symptoms. A pre-natal diagnosis is simple and effective, and allows an early thoracoscopic surgical treatment. A retrospective study was performed to assess management in two different populations of adults and children to define the best strategy.
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Affiliation(s)
- Lucile Fievet
- Department of Paediatric Surgery, Timone and North Children's Hospital, Aix-Marseille University and Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Claudia Natale
- Thoracic Surgery and Diseases of the Esophagus, North Hospital, Aix-Marseille University and Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Xavier-Benoit D'Journo
- Thoracic Surgery and Diseases of the Esophagus, North Hospital, Aix-Marseille University and Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Stéphanie Coze
- Department of Pediatric and Prenatal Imaging, Timone and North Hospital, Aix-Marseille University and Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Jean-Christophe Dubus
- Department of Pediatric Pneumology, Timone and North Children's Hospital, Aix-Marseille University and Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Jean-Michel Guys
- Department of Paediatric Surgery, Timone and North Children's Hospital, Aix-Marseille University and Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Pascal Thomas
- Thoracic Surgery and Diseases of the Esophagus, North Hospital, Aix-Marseille University and Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Pascal De Lagausie
- Department of Paediatric Surgery, Timone and North Children's Hospital, Aix-Marseille University and Assistance Publique-Hôpitaux de Marseille, Marseille, France
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Hui DS, Shavelle DM, Starnes VA, McFadden PM. Concurrent aortic valvular disease and pulmonary sequestration: clinical implications. Tex Heart Inst J 2015; 41:649-52. [PMID: 25593534 DOI: 10.14503/thij-13-3907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Pulmonary sequestration refers to segmental lung tissue that has no connection with the bronchial tree or pulmonary arteries. In adults, the clinical sequelae are usually related to infection. Patients are typically referred for sequestrectomy even when they are asymptomatic. There are no guidelines for treating patients who have pulmonary sequestration and coexisting cardiac valvular disease, in which case the venous drainage patterns of sequestra pose the additional risks of infective endocarditis and volume overload. We present the cases of 2 adult patients--one symptomatic and one asymptomatic--who had concurrent aortic valvular disease and pulmonary sequestration, and we discuss the factors involved in our evaluation of their cardiac risk and our treatment decisions. In view of the sparse data to predict cardiac risks, we think that pulmonary sequestrectomy in adult patients with concurrent valvular conditions should be considered on a case-by-case basis.
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Haider A, Hoonpongsimanont W. Uncommon etiology of chest pain: pulmonary sequestration. West J Emerg Med 2014; 14:638-9. [PMID: 24381687 PMCID: PMC3876310 DOI: 10.5811/westjem.2013.7.17533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 06/03/2013] [Accepted: 07/10/2013] [Indexed: 11/28/2022] Open
Abstract
Chest pain is a common presenting symptom in the emergency department. After ruling out emergent causes, emergency physicians need to identify and manage less commonly encountered conditions. Pulmonary sequestration (PS) is a rare congenital condition involving pulmonary parenchyma. In PS, a portion of non-functional lung tissue receives systemic blood supply from an anomalous artery. While most individuals with PS present in early life with symptoms of difficulty feeding, cyanosis, and dyspnea, some present later with recurrent pneumonia, hemoptysis, or productive cough. In this report, we present a case of PS in an adult with acute onset pleuritic chest pain.
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Affiliation(s)
- Asghar Haider
- University of California Irvine, School of Medicine, Irvine, California
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Koh WJ, Hong G, Kim K, Ahn S, Han J. Pulmonary sequestration infected with nontuberculous mycobacteria: a report of two cases and literature review. ASIAN PAC J TROP MED 2013; 5:917-9. [PMID: 23146810 DOI: 10.1016/s1995-7645(12)60172-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2012] [Revised: 08/15/2012] [Accepted: 09/15/2012] [Indexed: 11/18/2022] Open
Abstract
We report two cases of pulmonary sequestration infected with nontuberculous mycobacteria (NTM): Mycobacterium avium and Mycobacterium abscessus. Chest computed tomography showed pneumonic consolidation in the right lower lobe, which received a systemic blood supply from the descending aorta in both patients. Video-assisted thoracoscopic surgeries were successfully performed and pathological examinations revealed multiple caseating granulomas. A review of the literature revealed only seven previous case reports of pulmonary sequestration infected with NTM, and no case with Mycobacterium abscessus has been reported.
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Affiliation(s)
- Won-Jung Koh
- Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, South Korea.
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Wei Y, Chen L, Xu J, Yu D. Intrapericardial extralobar pulmonary sequestration in adult. Ann Thorac Surg 2013; 95:1093-6. [PMID: 23438544 DOI: 10.1016/j.athoracsur.2012.07.082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2012] [Revised: 07/19/2012] [Accepted: 07/23/2012] [Indexed: 11/29/2022]
Abstract
Extralobar pulmonary sequestration is a rare congenital pulmonary malformation compared with its counterpart, intralobar pulmonary sequestration, and occurs less in females. Here we describe a 24-year-old woman who underwent a median sternotomy for resection of an intrapericardial extralobar pulmonary sequestration. At her month follow-up visit, she had recovered well with no complications.
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Affiliation(s)
- Yiping Wei
- Department of Cardiothoracic Surgery, the Second Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China.
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