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.