Document Type : case report
Authors
1 Pediatric assistance of mashhad university medical sciences, Department of pediatric ghaem hospital in mashhad
2 Department of radiology Dr shariati hospital, mashhad university medical sciences, Mashhad Iran
3 Clinical Research Development Unit of Akbar Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
4 Lung Diseases Research Center,Mashhad University of Medical Sciences,Mashhad,Iran
Abstract
Background: Pulmonary sequestration (PS) is characterized by a separate segment of the lung that receives anomalous vascular supply separate from the pulmonary arteries. Here we report the case of a 4-year-old girl with dyspnea and recurrent pneumonia who was finally diagnosed as a case of PS.
Case presentation: A 4-year-old girl was admitted to Imam-Reza hospital, Mashhad city, Iran, with a history of coughing and dyspnea from two years ago. On the CXR, consolidation can be seen in the left lower lobe. As there was a high likelihood of aspiration or pneumonia following her past medical history, the patient underwent bronchoscopy. More investigation with HRCT revealed vascular anomaly. CMRI (Cardiac Magnetic Resonance Imaging) showed no cardiac abnormality. More findings showed a large collateral artery originated from left lateral side of abdominal aorta. This collateral artery went upward to the LLLL (the Lower Lobe of Left Lung) and anastomosed directly with two large posterior segmental tributary of the left lung pulmonary veins. Hyper-vascular pattern of both lungs was also observed in the MRI.
Conclusion: To avoid misdiagnosis, PS should be considered in differential diagnosis in infants with chronic cough and dyspnea. These patients should be referred to a tertiary center to receive appropriate treatment.
Keywords
- Nadeem M, Elnazir B, Greally P. Congenital pulmonary malformation in children. Scientifica. 2012; 2012:209896-.
- Tashtoush B, Memarpour R, Gonzalez J, Gleason JB, Hadeh A. Pulmonary Sequestration: A 29 Patient Case Series and Review. Journal of clinical and diagnostic research: JCDR. 2015; 9(12):AC05-AC8.
- Chakraborty RK, Sharma S. Pulmonary Sequestration. StatPearls. Treasure Island (FL): StatPearls Publishing
StatPearls Publishing LLC; 2018.
- Long Q, Zha Y, Yang Z. Evaluation of pulmonary sequestration with multidetector computed tomography angiography in a select cohort of patients: A retrospective study. Clinics (Sao Paulo, Brazil). 2016; 71(7):392-8.
- Traibi A, Seguin-Givelet A, Brian E, Grigoroiu M, Gossot D. Adult pulmonary intralobar sequestrations: changes in the surgical management. Journal of visualized surgery. 2018; 4:62-.
- Karakas SP, Morrison S, Soldes O. Unilateral Coexisting Intralobar and Extralobar Pulmonary Sequestrations. Radiology case reports. 2015; 3(3):171-.
- Choplin RH, Siegel MJ. Pulmonary sequestration: six unusual presentations. AJR American journal of roentgenology. 1980; 134(4):695-700.
- Solit R, Fraimow W, Wallace S, Cohn HJTJot, surgery c. The effect of intralobar pulmonary sequestration on cardiac output. 1965; 49:844.
- Lin C-H, Chuang C-Y, Hsia J-Y, Lee M-C, Shai S-E, Yang S-S, et al. Pulmonary sequestration—differences in diagnosis and treatment in a single institution. Journal of the Chinese Medical Association. 2013; 76(7):385-9.
- Savic B, Birtel FJ, Tholen W, Funke HD, Knoche R. Lung sequestration: report of seven cases and review of 540 published cases. Thorax. 1979; 34(1):96-101.
- Belchis D, Cowan M, Mortman K, Rezvani B. Adenocarcinoma arising in an extralobar sequestration: a case report and review of the literature. Lung cancer (Amsterdam, Netherlands). 2014; 84(1):92-5.
- Rajendiran S, Kapoor V, Schoedel K. Fine-needle aspiration cytology of intraabdominal extralobar pulmonary sequestration: a case report. Diagnostic cytopathology. 2003; 29(1):24-7.
- Andrade CF, Ferreira HP, Fischer GB. Congenital lung malformations. Jornal brasileiro de pneumologia: publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia. 2011; 37(2):259-71.
- Rossi JB. Atypical pulmonary sequestration causing respiratory distress in a 2-month-old male infant. Pediatric surgery international. 2017; 33(7):807-11.
- Wani SA, Mufti GN, Bhat NA, Baba AAJCrip. Pulmonary sequestration: early diagnosis and management. 2015; 2015.
)