Final Diagnosis - Clinical Correlations

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Final Diagnosis
Intralobar Pulmonary Sequestration
8/15/2005
History of recurrent pneumonia
Surgical Report
• Intralobar Pulmonary Sequestration, treated with
right lower lobectomy
• Two major arteries from the thoracic aorta
• Large vein draining sequestered lobe
Bronchopulmonary Sequestration
Definition
• Non-functioning lung tissue
• Separated from normal bronchial tree
• Vascularized by a systemic artery
Two Forms
• Intralobar (ILS): within the visceral pleura
• Extralobar (ELS): separated from the lung by its
own pleura
Intralobar Pulmonary Sequestration (ILS)
Characteristics
• More common type
• May present at any age
• Generally as recurrent infection
• No sexual predominance
• Almost exclusively affects lower lobe
• Arterial supply: descending aorta
• Venous drainage: pulmonary veins
Etiology of
Bronchopulmonary
Sequestration
• Accessory bud that forms caudal to lung buds
• Traction theory
• Postnatal formation
Pulmonary Sequestration
Complications
• Recurrent infection
• Heart failure
• Intralobar malignancy
Treatment of Pulmonary Sequestration
Symptomatic Disease
• Surgery: lobectomy or segmental resection
• Arterial embolization
Patient Follow-up
• Given granulomas and acid fast bacilli, sputum
was sent for culture. Three sputum samples
were negative for acid fast bacilli. A ppd was
placed and was also negative.
• Patient was treated empirically with IRPE for
four months.
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