ABSTRACT
Se presentó una mujer de 40 años con antecedentes de asma bronquial atendida en el Hospital Clínico Quirúrgico "Hermanos Ameijeiras" de La Habana. Refirió historia de un mes de evolución de tos seca, dolor torácico en hemitórax izquierdo, falta de aire y en dos ocasiones fiebre de 38 °C. Cumplió tratamiento para el proceso infeccioso respiratorio sin resolución. En la radiografía de tórax se evidenció una lesión radiopaca en el lóbulo inferior izquierdo y se confirmó el secuestro pulmonar intralobar con la angiotomografía pulmonar. En el secuestro pulmonar se requiere del uso adecuado de método clínico para su diagnóstico y la toma de decisiones terapéuticas definitivas(AU)
Forty years old woman with a history of severe asthma assisted to the Hospital Clínico Quirúrgico "Hermanos Ameijeiras" in Havana, presenting the following symptoms: dry cough, chest pain in left hemithorax, shortness of breath and fever with a temperature of 38°C (100.4°F) twice in the month. The patient was under treatment to control a respiratory infection, with no resolution reported. Radiography of the thorax revealed a radiopaque lesion in the left lower lobe, and lung sequestration was confirmed by pulmonary angiography. An appropiate use of clinical methods is required to diagnose and undertake the right therapy decisions about the intralobar lung sequestration(AU)
Subject(s)
Humans , Female , Adult , Bronchopulmonary Sequestration/diagnosis , Bronchopulmonary Sequestration/diagnostic imagingABSTRACT
RESUMEN Se presentó una mujer de 40 años con antecedentes de asma bronquial atendida en el Hospital Clínico Quirúrgico Hermanos Ameijeiras de La Habana. Refirió historia de un mes de evolución de tos seca, dolor torácico en hemitórax izquierdo, falta de aire y en dos ocasiones fiebre de 38 °C. Cumplió tratamiento para el proceso infeccioso respiratorio sin resolución. En la radiografía de tórax se evidenció una lesión radiopaca en el lóbulo inferior izquierdo y se confirmó el secuestro pulmonar intralobar con la angiotomografía pulmonar. En el secuestro pulmonar se requiere del uso adecuado de método clínico para su diagnóstico y la toma de decisiones terapéuticas definitivas.
ABSTRACT Forty years old woman with a history of severe asthma assisted to the Hospital Clínico Quirúrgico Hermanos Ameijeiras in Havana, presenting the following symptoms: dry cough, chest pain in left hemithorax, shortness of breath and fever with a temperature of 38°C twice in the month. The patient was under treatment to control a respiratory infection, with no resolution reported. Radiography of the thorax revealed a radiopaque lesion in the left lower lobe, and lung sequestration was confirmed by pulmonary angiography. An appropiate use of clinical methods is required to diagnose and undertake the right therapy decisions about the intralobar lung sequestration.
Subject(s)
Female , Bronchopulmonary Sequestration/diagnosis , Bronchopulmonary Sequestration/drug therapy , Asthma , MethodsABSTRACT
CCAM with no other anomalies such as sequestration receives its blood supply from the pulmonary artery. Our case presented with a simple CCAM and no other anomalies but with a feeding artery. Although preoperative evaluation may not show feeding arteries, they may exist in congenital cystic lung diseases.
Subject(s)
Arteries , Cystic Adenomatoid Malformation of Lung, Congenital , Lung Diseases , Pulmonary ArteryABSTRACT
BACKGROUND: Congenital cystic diseases of the lung are uncommon, and they share similar embryogenic and clinical characteristics. But they are sometimes vary widely in their presentation and severity. Therefore they are often difficult to make different diagnosis each other, and all require surgical treatment. MATERIAL AND METHOD: From 1993 to 2006, 38 patients underwent surgical procedures under these diagnostic categories in the Depart. of Thoracic and Cardiovascular Surgery, Busan-Paik Hospital, College of Medicine, Inje University. And we retrospectively reviewed these patients' charts for clinical presentations, surgical procedures, pathologic findings and postoperative morbidity and mortality. RESULT: There were 22 males and 16 females, ages ranged from 1 month after birth to 51 years and mean age was 20.8 years. The main symptoms were 19 fever, cough, sputum production due to recurrent infection, 7 dyspnea, 8 chest discomfort, 4 hemoptysis, but eight patients were asymptomatic. Computed tomography was chosen as diagnostic modalities and available for operation plan for all of patients. For all the cases, surgical resection were performed. Lobectomy was performed in 28 patients, simple excision (resection) in 8 patients, segmentectomy or wedge resection in 2 patients. There were 10 pulmonary sequestrations, 15 congenital cystic adenomatoid malformations (CCAM), 11 bronchogenic cysts, and 2 congenital lobar emphysemas. They all were confirmed by pathologic exams. The complications were 6 wound disruption or infection, 2 chylothorax, 1 ulnar neuropathy, but all of them were resolved uneventful. There was no persistent air leakage, respiratory failure, operative mortality and recurrence. CONCLUSION: We performed immediate surgical removal of congenital cystic lung lesions after diagnosis and obtained good results, so reported them with literature review.
Subject(s)
Female , Humans , Male , Bronchogenic Cyst , Bronchopulmonary Sequestration , Chylothorax , Cough , Cystic Adenomatoid Malformation of Lung, Congenital , Dyspnea , Emphysema , Fever , Hemoptysis , Lung , Lung Diseases , Mastectomy, Segmental , Parturition , Recurrence , Respiratory Insufficiency , Retrospective Studies , Sputum , Thorax , Ulnar NeuropathiesABSTRACT
An anomalous systemic arterial supply to the left basal segments without sequestration is a rare congenital abnormality within the spectrum of pulmonary sequestration. But this is rather different from the definition of pulmonary sequestration in that it has normal bronchial connections. We describe here our experience with surgical treatments for an anomalous systemic arterial supply to the left basal segments without sequestration, and this condition was confirmed preoperatively.
Subject(s)
Bronchopulmonary Sequestration , Congenital AbnormalitiesABSTRACT
A 60-year-old female entered the emergency unit with a chief complaint of hemoptysis. Based on the computer tomographic image analysis of the chest, the patient was diagnosed as having an intralobar pulmonary sequestration that accompanied a hemothorax, and the hemothorax was do to the rupture of a pseudocyst. Pulmonary lobectomy of the left lower lobe and primary closure of an aberrant artery were both performed as an emergency operation. After one week following the operation, the patient was discharged without any postoperative complications.
Subject(s)
Female , Humans , Middle Aged , Arteries , Bronchopulmonary Sequestration , Emergencies , Emergency Service, Hospital , Hemoptysis , Hemothorax , Postoperative Complications , Rupture , ThoraxABSTRACT
A 42-year-old female was admitted to our hospital complaining of a dyspnea. Chest X-ray showed left atelectasis. A mass was detected in left main bronchus by computed tomography and bronchoscopy. The mass was diagnosed as a endobronchial leiomyoma by biopsy exam. After open thoracotomy and bronchotomy, mass removal was done and middle lobe was ventilated normally. Aberrant arterial supply from descending aorta to left lower lobe of the lung was detected and left lower lobectomy was done. The lower lobe of the left lung was pathologically diagnosed as intralobar pulmonary sequestration. Herein we report a rare coexistent case of endobronchial leiomyoma and intralobar pulmonary sequestration.
Subject(s)
Adult , Female , Humans , Aorta, Thoracic , Biopsy , Bronchi , Bronchial Neoplasms , Bronchopulmonary Sequestration , Bronchoscopy , Dyspnea , Leiomyoma , Lung , Pulmonary Atelectasis , Thoracotomy , ThoraxABSTRACT
Anomalous systemic arterial supply to the normal basal segments with normal bronchial connection of the lung without sequestration is a rare anomaly. It was classified as a type of sequestration according to Pryce's terminology, but whether the term - one of the sequestration is appropriate or not, is controversial because of normal bronchial connection. We describe our experience with surgical treatments for anomalous arterial supply to the normal basal segments of the left lower lobe.
Subject(s)
Lung , Pulmonary ArteryABSTRACT
BACKGROUND: Intralobar and extralobar pulmonary sequestrations have been considered as congenital lesions that occur at different stages of embryonic life. However, most cases of intralobar pulmonary sequestration (IPS) seem to have an acquired origin, as they are absent in infants and associated anomalies are relatively uncommon among them. MATERIAL AND METHOD: The cases of 25 patients who were diagnosed as IPS after surgical resection from December, 1985 to July, 2002 were included in this study. The medical records were retrospectively reviewed and the clinical characteristics were age at operation; gender; symptoms at presentation; presence of congenital anomalies; combined diseases; preoperative studies and diagnosis; location of the lesion; method of surgical resection; origin, size and numbers of aberrant artery; histopathological findings; and postoperative complications. RESULT: There were 17 (68%) female patients and 8 (32%) male patients, their ages ranged from 1 to 57 and mean value was 23 years old. Though 14 patients (56%) complained of respiratory symptoms such as pneumonia and recurrent respiratory infections, a large number of patients (44%) were asymptomatic or had chest pain only when the lesion was discovered. Only 8 patients (32%) were diagnosed as pulmonary sequestration preoperatively and 8 (32%) were suspected as mediastinal or lung tumor, 5 (20%) were congenital or acquired cystic lung disease, and 4 (16%) were lung abscess or bronchiectasis, respectively. The majority of aberrant arteries (86.4%) confirmed during the operation were originated from thoracic aorta and 2 were thoracic and abdominal aorta, 1 was abdominal aorta, respectively. The younger patients (less than 10 years old) had more other congenital anomalies (30% vs 6.7%) but the proportion of congenital IPS was not signifi cantly different (10% vs 6.7%, p>0.05) compared with elder patients. Histopathologically, almost all lesions showed chronic inflammation, cystic changes and similar pleural adhesions regardless of age. CONCLUSION: The large portion of the patients with IPS (44%) was clinically asymptomatic or presented non-respiratory symptoms at diagnosis and likely to be diagnosed as mediastinal or lung tumor especially in elder patients. Though the younger patients had more other congenital anomalies, most cases of IPS proved to be acquired lesions in terms of the histopathlogical findings and the proportion of congenital evidences.
Subject(s)
Female , Humans , Infant , Male , Young Adult , Aorta, Abdominal , Aorta, Thoracic , Arteries , Bronchiectasis , Bronchopulmonary Sequestration , Chest Pain , Diagnosis , Inflammation , Lung , Lung Abscess , Lung Diseases , Medical Records , Pneumonia , Postoperative Complications , Respiratory Tract Infections , Retrospective StudiesABSTRACT
Pulmonary sequestration is a very rare congenital malfomation, especially when it is located in the infradiaphragmatic retroperitoneal space. The patient was a 56-year-old man with no respiratory symptom but had some postprandial epigastric discomfort for several days. Plain chest x-ray revealed mild elevation of left diaphragm and abdominal CT scan showed large cystic retroperitoneal mass with some calcification. We performed the operation through the thorachoabdominal incision and the mass was proven to be a pulmonary sequestration. Therefore, we report the case with review of literatures.
Subject(s)
Humans , Middle Aged , Bronchopulmonary Sequestration , Diaphragm , Retroperitoneal Space , Thorax , Tomography, X-Ray ComputedABSTRACT
Extralobar pulmonary sequestration, a rare form of bronchopulmonary sequestration, is a congenital anomaly in which a portion of nonfunctioning lung tissue is surrounded by its own pleura and is supplied by a systemic artery. We describe a case of extralobar pulmonary sequestration with unusual features. CT scanning of the chest demonstrated a non-enhancing, hyperdense mass within the right major fissure, and thoracotomy revealed that the mass received blood from a branch of the right pulmonary artery and drained into the left atrium. The pathologic diagnosis was extralobar pulmonary sequestration.
Subject(s)
Arteries , Bronchopulmonary Sequestration , Diagnosis , Heart Atria , Lung , Pleura , Pulmonary Artery , Thoracotomy , Thorax , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: Pulmonary sequestration is not common and it's diagnosis needs special care such as an aortogram ar tomography. MATERIAL AND METHOD: We have experienced 13 patients who had pulmonary sequestration from January 1990 to September 1997. RESULT: Six men and seven women were treated and their mean age was 25.8+/-14.3 years. Their chief complaints were coughing, chest pain, and no symptoms in decreasing order. There were nine intralobar (ILS) and three extralobar (ELS) pulmonary sequestrations and one patient had both. There was no preference in location of either left or right. They were mainly diagnosed by aortography and their feeding arteries commonly originated from the lower thoracic aorta. The patients with ILS were treated by lobectomy and those with ELS by sequestrectomy. CONCLUSION: to treat pulmonary sequestration properhy, aortogram or chest CT is warranted to iidenty the abnormal origin of feeding artery.
Subject(s)
Female , Humans , Male , Aorta, Thoracic , Aortography , Arteries , Bronchopulmonary Sequestration , Chest Pain , Cough , Diagnosis , Tomography, X-Ray ComputedABSTRACT
Papillary adenoma of the lung is a very rare tumor in humans. Papillary adenoma is benign, and morphologically distinctive neoplasm.Since Fanton et al. firstly described a bronchial tumor showing Clara cell features,only a few cases having features of both Clara cells and type II pneumocytes have been reported.The immunohistochemical and ultrastructural findings hint at an origin from type II pneumocytes or Clara cells.Noguchi et al. demonstrated the presence of surfactant apoprotein in cytoplasm of tumor cells in a case of papillary adenoma indicating type II pneumocyte-like differenciation of the tumor cells. The tumor was encounted in a asymptomatic patient in a mass-survey chest X-ray examination. The chest X-ray films showed the tumor as well dermacated small lesion. We reports a case of papillary adenoma of the lung with pulmomary sequestration with review of articles.