Extralobar pulmonary sequestration in the abdominal cavity: an ultrasound case report


He, W.; Luo, S-Juan.; Chu, L.

Quantitative Imaging in Medicine and Surgery 3(1): 59-60

2013


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Video
of
the
Issue
Extralobar
pulmonary
sequestration
in
the
abdominal
cavity:
an
ultrasound
case
report
Wei
He',
Sheng-Juan
Luce',
Ling
Chu
g
'Department
of
Ultrasonography,
Third
Xiangya
Hospital
of
Central
South
University,
Changsha,
Hunan
410013,
China;
'Department
of
Pathology,
Third
Xiangya
Hospital
of
Central
South
University,
Changsha,
Hunan
410013,
China
Corresponding
to:
Dr.
Wei
He.
Department
of
Ultrasonography,
Third
Xiangya
Hospital
of
Central
South
University,
Changsha,
Hunan
410013,
China.
Email:
heweihn@l63.com.
Effii
ND
Submitted
Jan
24,
2013.
Accepted
for
publication
Feb
20,
2013.
doi:
10.3978/j.issn.2223-4292.2013.02.02
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A
28-year-old
woman,
with
unremarkable
family
history,
presented
to
our
unit
at
26
weeks
of
her
pregnancy
(G1P0).
Her
ultrasound
scan
at
13
weeks
was
normal.
Her
previous
laboratory
tests
did
not
show
any
abnormalities.
Our
ultrasound
examination
revealed
following
findings:
A
homogeneously
hyperechoic
lesion
below
the
left
diaphragm
were
found
on
the
left
parasagittal
view
(Figure
1A,
Video
1).
This
lesion
had
a
round
shape
and
located
below
the
left
ventricle
of
heart
while
above
the
left
kidney.
On
the
transverse
view
of
upper
abdomen,
the
lesion
was
right
behind
the
stomach
and
parallel
with
the
right
kidney
(Figure
1B).
Figure
/C
showed
its
feeding
vascular
pedicles
branched
off
from
the
abdominal
artery
and
pulsed
wave
Doppler
showed
low
resistance
(Figure
1D).
The
woman
was
counseled
regarding
pulmonary
sequestration
and
some
rare
retroperitoneal
tumors
as
possible
diagnoses
and
their
possible
outcomes.
She
chose
to
give
up
the
fetus
and
underwent
artificial
abortion.
Surgical
removal
was
performed
afterwards
with
her
consent
and
the
diagnosis
of
extralobar
pulmonary
sequestration
in
the
abdominal
cavity
was
finally
confirmed.
Macroscopically
the
lesion
was
located
under
the
left
diaphragm
and
had
a
fishmeat-like
color,
spongy
consistence,
and
the
sections
presented
randomly
distributed
cystic
areas.
The
external
surface
of
the
mass
was
smooth
and
covered
by
pleural
tissue
(Figure
1E).
Microscopic
examination
of
the
lesion
revealed
that
it
was
formed
totally
of
normal
lung
tissue
with normal
bronchi
and
bronchioles
surrounded
by
incomplete
cartilaginous
rings
(Figure
1F).
Pulmonary
sequestration
(PS)
is
a
rare
congenital
malformation
of
the
lower
respiratory
tract.
It
consists
Video
1
Video
clip
of
ultrasonography
demonstrating
the
mass
in
real-time
of
a
nonfunctioning
mass
of
normal
lung
tissue
that
lacks
normal
communication
with
the
tracheobronchial
tree,
and
that
receives
its
arterial
blood
supply
from
the
systemic
circulation.
Sequestrations
are
classified
anatomically:
(I)
Intralobar
sequestration
(ILS)
in
which
the
lesion
is
located
within
a
normal
lobe
and
lacks
its
own
visceral
pleura;
(II)
Extralobar
sequestration
(ELS)
in
which
the
mass
is
located
outside
the
normal
lung
and
has
its
own
visceral
pleura
(1,2).
The
PS
is
a
rare
anomaly
which
is
lying
mostly
at
the
base
of
the
left
side
of
the
thorax,
but
could
be
found
on
the
right
side
and
in
the
mediastinum
at
any
level
from
the
neck
to
below
the
diaphragm
(3).
The
fetus
we
encountered
is
such
an
extremely
rare
case.
Quant
Imaging
Med
Surg
2013;3(1):59-60
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He
et
al.
Extralobar
pulmonary
sequestration
in
the
abdominal
cavity
A
-41111—
ST
.
H
C
AO
RK
ST
Left
Diaphragm
-4
11
\
M
t
1'
I
,
441
1.
%
LK
Figure
1
A.
Parasagittal
scan
demonstrating
the
mass
(M)
in
the
abdominal
cavity
(arrow);
B.
Transverse
scan
of
the
upper
abdomen
demonstrating
the
mass
(arrow).
C.
Color
Doppler
sonogram
of
the
mass
demonstrating
its
feeding
vessels;
D.
Pulsed
wave
Doppler
sonogram
showing
feeding
vessels
of
low-resistance
artery
nature;
E.
Macroscopic
inspection;
F.
Microscopic
examination.
H,
heart;
ST,
stomach;
LK,
left
kidney;
RK,
right
kidney
Acknowledgements
Disclosure:
The
authors
declare
no
conflict
of
interest.
References
1.
Fabre
OH,
Porte
HL,
Godart
FR,
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al.
Long-term
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Ann
Thorac
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1998;65:1144-6.
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Savic
B,
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FJ,
Tholen
W,
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Lung
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and
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Thorax
1979;34:96-101.
3.
Ferguson
TB.
Congenital
lesions
of
the
lungs
and
emphysema.
In:
Sabiston
DC,
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FC,
eds.
Surgery
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Philadelphia:
WB
Saunders
Co.
1983:668-709.
Cite
this
article
as:
He
W,
Luo
SJ,
Chu
L.
Extralobar
pulmonary
sequestration
in
the
abdominal
cavity:
an
ultrasound
case
report.
Quant
Imaging
Med
Surg
2013;3(1):59-60.
doi:
10.3978/j.issn.2223-4292.2013.02.02
Quant
Imaging
Med
Surg
2013;3(1):59-60