Presentation
Routine antenatal 2nd trimester ultrasound
Patient Data
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 colour Doppler sonogram demonstrated an ectopic blood supply to the mass from the thoracic aorta - diameter of the supplying vessel was 3.4 mm.
Case Discussion
Bronchopulmonary sequestration (BPS) is a rare congenital malformation of the lower respiratory tract.
It consists of a non-functioning 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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