Pulmonary sequestration (extralobar)

Last revised by Hoe Han Guan on 28 Mar 2023

Extralobar pulmonary sequestration (ELS) is a subtype of pulmonary sequestration, the other type being intralobar pulmonary sequestration (ILS).

It is usually encountered in infants, most being diagnosed before six months. It is more common in males (M:F 4:1).

Extralobar pulmonary sequestration is the less common type of pulmonary sequestration, accounting only for 15-25%.

It is covered by its own pleura and this is what differentiates it from intralobar pulmonary sequestration. 

Extralobar pulmonary sequestration receives vascular supply mainly from the aorta (thoracic or abdominal) or from other arterial vessels (splenic, subclavian, gastric, intercostal or multiple vessels) and venous drainage can be either systemic or pulmonary. 

There is strong predilection towards the left lower lobe (65-90%).

  • well marginated mass

  • usually homogeneous, often without internal gas

  • may contain cystic areas

  • systemic arterial supply 4

Surgical excision is the mainstay of treatment.

Furthermore, in an infra-diaphragmatic location, consider 6:

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