Intralobar pulmonary sequestration in elderly woman: a rare case report with emphasis on imaging findings

Hassan, Qays A.; Al-Shamseei, Hind Fadhil

doi:10.1016/j.radcr.2016.05.004

Cited by 13 publications

(15 citation statements)

References 12 publications

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“…It has been reported that 60% of ILPS is diagnosed before the age of 20, and it is seldom found in patients aged 40 years or older [1]. Because of the nonspecific symptoms, it is often difficult to diagnose without direct investigation, and imaging of the vasculature and pulmonary parenchyma is done [4].…”

Section: Discussionmentioning

confidence: 99%

Coil embolization of intralobar pulmonary sequestration - an alternative to surgery: a case report

et al. 2018

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BackgroundPulmonary sequestration is a congenital lung disease characterized by nonfunctioning pulmonary tissue that lacks normal communication with the bronchial tree and is supplied by a nonpulmonary systemic artery. Symptomatic bronchopulmonary sequestration is uncommon, seen more frequently in the pediatric population than in adults. It has traditionally been treated with surgical resection; however, a limited but growing number of cases have been treated with angiographic embolization. Given the inherent risks of cardiothoracic surgery, embolization of the anomalous vessel is an enticing alternative treatment. We present a case of a 56-year-old woman with known, symptomatic, intralobar pulmonary sequestration that was successfully treated with coil embolization.Case presentationA 56-year-old Pacific Islander woman with a history of chronic myeloid leukemia was admitted to the hospital with an episode of hemoptysis. Computed tomography of the chest demonstrated left lower lobe intralobar pulmonary sequestration fed by a large tortuous vessel branching off of the descending thoracic aorta. Surgical resection of the sequestration is the current standard treatment strategy of symptomatic intralobar pulmonary sequestration. The cardiothoracic surgeon noted that given the size and location of arterial blood supply, intervention would involve thoracotomy and lobectomy. The interventional radiologist offered embolization of the lesion as an alternative to surgery. Multiple coils, 6–13 mm in size, were used to embolize the sequestration. No considerable flow distal to the coils was noted postembolization.ConclusionsIntralobar pulmonary sequestration is a rare condition that typically requires surgical management. This case demonstrates the efficacy of coil embolization as an alternative management strategy. To date, limited case reports of adults treated with endovascular embolization exist. Treatment of symptomatic pulmonary sequestration with embolization can be considered as an alternative to surgical resection.

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Section: Discussionmentioning

confidence: 99%

Coil embolization of intralobar pulmonary sequestration - an alternative to surgery: a case report

et al. 2018

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“…The sequestration subsequently receives systemic arterial supply instead of the normal pulmonary arterial supply . Intralobar pulmonary sequestrations receive anomalous systemic arterial supply predominantly deriving from the descending thoracic aorta (72%), abdominal aorta (21%), and, rarely, the intercostal arteries (3%) . The majority of intralobar sequestrations are drained by normal pulmonary veins into the left atrium .…”

Section: Discussionmentioning

confidence: 99%

“…Patients can present with an incidental pulmonary lesion on imaging while asymptomatic . However, patients may present with cough, fever, recurrent pneumonia, chest pain, and in a small number of cases, hemoptysis.…”

Section: Discussionmentioning

confidence: 99%

“…5 Patients can present with an incidental pulmonary lesion on imaging while asymptomatic. 6 However, patients may present with cough, fever, recurrent pneumonia, chest pain, and in a small number of cases, hemoptysis. A study of 73 cases revealed presenting symptoms of pneumonia (n = 11), pneumothorax (n = 2), pneumomediastinum (n = 1), and respiratory distress (n = 6).…”

Section: Discussionmentioning

confidence: 99%

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Intralobar pulmonary sequestration originating from the intercostal arteries treated with surgical resection

Rehman

et al. 2018

Thoracic Cancer

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Intralobar pulmonary sequestration originating from the intercostal arteries is rarely reported. Herein, we report an unusual case of a 56‐year‐old male patient with intralobar pulmonary sequestration supplied from the intercostal arteries on the left lower lobe who presented after a month of a repeated cough and massive hemoptysis. Although transcatheter arterial embolization was performed three times, the patient's symptoms were not relieved. A left lower lobectomy was performed with video‐assisted thoracic surgery. At the six‐month follow‐up after surgery, the patient had recovered well without any hemoptysis. Therefore, surgical resection with lobectomy may be a better alternative to transcatheter arterial embolization for the treatment of intralobar pulmonary sequestrations arising from the intercostal arteries. To our knowledge, this is the second reported case of intralobar pulmonary sequestration arising from the intercostal arteries.

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“…15 It should be noted that this type of malformation is diagnosed extremely rarely in individuals older than 60 years. 13,14 Montjoy et al reported three adult patients with pulmonary sequestration; they were aged 57 to 62 years, 8 and the oldest patient in the Gompelmann series from Germany was 59 years old. 7 In a large series from Florida including 29 patients with pulmonary sequestration published by Tashtoush et al, almost two thirds of individuals were adults, with the oldest being 70 years old.…”

Section: Discussionmentioning

confidence: 99%

Lung Sequestration in an Octogenarian Male

Bonatti¹,

Smorzanek²,

Brennan³

2017

US Respiratory &Amp; Pulmonary Diseases

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Lung sequestration is a congenital disorder in which the lung parenchyma is not attached to the bronchial system, with blood supply originating from the aorta or various peripheral arteries. It may cause chronic pulmonary infection or bleeding and may require surgical resection. An 80-year-old male was incidentally found to have a paravertebral right thoracic mass. Computed tomography scan with contrast suggested a feeding vessel from the supraceliac aorta and suspicion of a lung sequestration was confirmed on selective angiography. He developed chronic cough, but this was managed symptomatically and no specific treatment, such as surgical resection, was necessary. Lung sequestration in the elderly is a rare condition but should be considered in a patient presenting with stable lung lesions, especially if a feeding artery from the aorta can be identified.

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Intralobar pulmonary sequestration in elderly woman: a rare case report with emphasis on imaging findings

Cited by 13 publications

References 12 publications

Coil embolization of intralobar pulmonary sequestration - an alternative to surgery: a case report

Coil embolization of intralobar pulmonary sequestration - an alternative to surgery: a case report

Intralobar pulmonary sequestration originating from the intercostal arteries treated with surgical resection

Lung Sequestration in an Octogenarian Male

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