Clinical, Imaging And Pathological Features Of Pulmonary Sequestration: An Analysis Of 43 Cases

Objective:The purposes of this project are:1. to explore the clinical characteristics, imaging manifestations, pathological features and complications of pulmonary sequestration (PS).2. to explore the choice of diagnostic methods of PS for improving the rate of preoperative diagnosis of PS and reducing the probability of misdiagnosis and missed diagnosis.3. propose a safer and more effective treatment to retain more pulmonary function of the patients and improve the prognosis according to the progress in the treatment of pulmonary sequestration.Methods:The data of 43 patients with pulmonary sequestration diagnosed in the First Affiliated Hospital of Zhejiang University Medical College from February 2008 to June 2014 were analyzed retrospectively. Clinical manifestation, imaging feature, pathological data, surgical method and prognosis of these patients were analyzed, and reviewed related literature.Results:Of the 43 cases, there were 27 males and 16 females, with a mean age of (38±14) years. The main clinical symptoms of PS were cough, sputum, fever and hemoptysis. The lesions appeared as solid mass in 21 cases, cyst in 13 cases, cystic-solid form in 7 cases, and atelectasis in 2 cases.26 cases were confirmed by thoracic radiology, and 40 cases were treated with surgical procedures,37 of whom were subjected to video-assisted thoracoscopic surgery. According to the findings during surgery,36 cases were intralobar PS and 4 cases were extralobar PS. The tissues were all detected dysplasia and chronic inflammatory by histopathological examinations. Three cases were managed by conservative treatment.Conclusion:PS is characterized by pulmonary dysplasia and abnormal arteries and its clinical manifestations are non-specific. The imaging manifestations of PS are various, main shown as pulmonary mass, and then followed by cystic lesion. A definite diagnosis is based on contrast-enhanced computed tomography combined with three-dimensional reconstruction. Surgical procedures are recommended once the diagnosis is confirmed. Video-assisted thoracoscopic surgery might be a good choice for PS.