Case Of the Week (COW) 29 Mar 2015
PRENATAL DIAGNOSIS OF EXTRALOBAR PULMONARY SEQUESTRATION
Findings
The left intrathoracic wedge-shaped hyperechogenic lesion, measuring 35 × 30 mm in size, situated at the lower portion of the left lung causing cardiac displacement to the right. Color doppler ultrasound showed a vessel arising from the descending aorta, which supplied the mass. And venous drainage into IVC DIAGNOSIS: Extra lobar Pulmonary Sequestration with feeding artery from descending thoracic aorta and draining vein into IVC.
Discussion
Differential diagnosis for fetal echogenic lung lesions: Congenital pulmonary adenomatoid malformation (CPAM), Broncho Pulmonary sequestration (PS) and Congenital diaphragmatic hernia (ususlly cystic). PULMONARY SEQUESTRATION: A rare congenital lung malformation comprising 0.5 to 6% of all congenital lung malformations. A mass of abnormal nonfunctioning pulmonary tissue Lacks communication with the bronchial tree, Receives blood supply arising from anomalous systemic vessel (instead of pulmonary arterial system) commonly from descending aorta. Usually occurs in left lower lung Two types of sequestration: Intralobar (75%) – within visceral pleura of pulmonary lobe. Venous drainage into pulmonary veins. Extralobar (25%)- accessory lung- tissue in its own pleura. venous drainage inyo IVC or azygos system. The appearance of pulmonary sequestration on prenatal ultrasound is similar to that of microcystic congenital cystic adenomatoid malformation. Identification of systemic vascular supply to the mass is important in distinguishing pulmonary sequestration from CPAM. Mixed or hybrid tumors containing both pulmonary sequestration and congenital cystic adenomatoid malformation.
Contributed By:
Prof. N. Kailasanathan, Dr. Rajalakshmi
Barnard Institute of Radiology
PRENATAL DIAGNOSIS OF EXTRALOBAR PULMONARY SEQUESTRATION
Findings
The left intrathoracic wedge-shaped hyperechogenic lesion, measuring 35 × 30 mm in size, situated at the lower portion of the left lung causing cardiac displacement to the right. Color doppler ultrasound showed a vessel arising from the descending aorta, which supplied the mass. And venous drainage into IVC DIAGNOSIS: Extra lobar Pulmonary Sequestration with feeding artery from descending thoracic aorta and draining vein into IVC.
Discussion
Differential diagnosis for fetal echogenic lung lesions: Congenital pulmonary adenomatoid malformation (CPAM), Broncho Pulmonary sequestration (PS) and Congenital diaphragmatic hernia (ususlly cystic). PULMONARY SEQUESTRATION: A rare congenital lung malformation comprising 0.5 to 6% of all congenital lung malformations. A mass of abnormal nonfunctioning pulmonary tissue Lacks communication with the bronchial tree, Receives blood supply arising from anomalous systemic vessel (instead of pulmonary arterial system) commonly from descending aorta. Usually occurs in left lower lung Two types of sequestration: Intralobar (75%) – within visceral pleura of pulmonary lobe. Venous drainage into pulmonary veins. Extralobar (25%)- accessory lung- tissue in its own pleura. venous drainage inyo IVC or azygos system. The appearance of pulmonary sequestration on prenatal ultrasound is similar to that of microcystic congenital cystic adenomatoid malformation. Identification of systemic vascular supply to the mass is important in distinguishing pulmonary sequestration from CPAM. Mixed or hybrid tumors containing both pulmonary sequestration and congenital cystic adenomatoid malformation.
Contributed By:
Prof. N. Kailasanathan, Dr. Rajalakshmi
Barnard Institute of Radiology