Clinical Manifestations Of Pulmonary Sequestration: 4 Cases Report And Literature Review

ObjectivesTo investigate the clinical presentations and features of pulmonary sequestration, and therefore to improve the diagnostic accuracy.Methods4 patients diagnosed as pulmonary sequestration in Sir Run Run Shaw Hospital from Jan,2008 to Jun,2010 were reviewed and analyzed. After preparation of clinical information materials of these patients, we analyzed the clinical characteristics, imaging, fibrobronchoscopy, treatment and prognosis retrospectively, and the literature were reviewed as well.Results3 cases,1 male and 2 females, aged from 24 to 31, were diagnosed with intralobar sequestration(ILS); 1 case, female, aged 60, with extralobar sequestration(ELS). Intermittent hemoptysis was presented in 1 ILS patient with the history of 18 years and other 2 had cough, expectoration and fever, including 1 female case with a concurrence of tuberculosis; The ELS patient was detected in a routine chest radiography, without any recorded complaints. The three ILS cases were initially mistaken for bronchiectasis or lung abscess. The ELS case was firstly misdiagnosed as a lung mass. The spiral CT of the ILS patients demonstrated thin shadows or massive consolidation with or without cystiform alterations and air bronchogram, mostly located at the left lower lung, and often with finding of aberrant feeding artery from systemic artery. With the ELS case, a well-defined cystic mass and aberrant feeding artery can be found in CT scan. In fibrobronchoscopy, no other abnormality can be found both in ILS and ELS cases except light congestion of bronchial mucosa.2 cases of ILS underwent lobectomy with excellent result and long-term favorable outcome,1 case concomitant with TB treated with antituberculosis, and 1 case of ELS was not treated.ConclusionsIn pulmonary sequestration, ILS occurs more frequently than ELS, the common symptoms are recurrent respiratory infection and hemoptysis. In ELS patients, usually there is no complaint. Chest spiral CT scan and three-dimensional reconstruction of blood vessels are usually helpful for the diagnosis. Once PS is diagnosed, surgery is suggested, and the common treatment is resection of the sequestered lobe and the clinical outcome is favorable.