Congenital pulmonary sequestration

Case contributed by Dr Manisha Langar

Presentation

Routine antenatal 2nd trimester ultrasound

Patient Data

Age: 26 years
Gender: Female
Modality: Ultrasound

A single viable fetus was seen in cephalic presentation. 

A large wedge shaped echogenic shadow was seen in the lower fetal left chest, pushing the cardia contralaterally. No internal cystic shadows were seen. A color Doppler sonogram demonstrated an ectopic blood supply to the mass from the thoracic aorta - diameter of the supplying vessel was 3.4mm. 

Case Discussion

  • Bronchopulmonary sequestration (BPS) is a rare congenital malformation of the lower respiratory tract.
  • It consists 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.
  • BPS is estimated to comprise 0.15 to 6.4 percent of all congenital pulmonary malformations, making it an extremely rare disorder.
  • Sequestrations are classified anatomically:
    • Intralobar sequestration (ILS) in which the lesion is located within a normal lobe and lacks its own visceral pleura.
    • Extralobar sequestration (ELS) in which the mass is located outside the normal lung and has its own visceral pleura
  • The blood supply of 75% of pulmonary sequestrations is derived from the thoracic or abdominal aorta.
  • The remaining 25% of sequestrations receive their blood flow from the subclavian, intercostal, pulmonary, pericardiophrenic, innominate, internal mammary, coeliac, splenic, or renal arteries.
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Case Information

rID: 27757
Case created: 18th Feb 2014
Last edited: 28th Sep 2015
System: Obstetrics
Inclusion in quiz mode: Excluded

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