Pulmonary sequestration: a comparison between pediatric and adult patients

Abstract

The extralobar type of sequestration often remains asymptomatic, and is usually an incidental finding during infancy. The intralobar type mostly presents with recurrent infections in adulthood resulting in more lobectomies. We believe these findings support our current policy to remove any pulmonary malformation whenever diagnosed in order to: (1), prevent infection and other potentially serious late complications which may compromise the surgical outcome; and (2), enhance the chance of a parenchymal-sparing resection.

Malformações pulmonares congênitas

“…Pulmonary sequestration accounts for 0.15-6.45% of all lung malformations (9)(10)(11)(12)(13)(14) and is characterized by normal, nonfunctioning lung tissue that has no connection with the bronchial tree and receives its blood supply from the systemic circulation. (4,10,(12)(13)(14) Pulmonary sequestrations can be classified as extralobar or intralobar depending on their location in relation to the adjacent normal lung and on their visceral pleural covering.…”

“…(4,10,(12)(13)(14) Pulmonary sequestrations can be classified as extralobar or intralobar depending on their location in relation to the adjacent normal lung and on their visceral pleural covering. (4,10,11,15) There is a third, rarer, extralobar pulmonary sequestration is composed of irregular bronchi and bronchioles, as well as by alveoli that are twice to five times their normal size.…”

“…(5,13,18) Case reports of concurrent extralobar and intralobar pulmonary sequestrations suggest that the two forms share a common embryonic origin. (10) The treatment of choice is surgical resection of the lesion through sequestrectomy or pulmonary lobectomy (3,4,11,12,14,15,20) at the time of diagnosis principally because of the possibility of recurrent infections, hemorrhage, malignant transformation, and other complications. However, there is still controversy as to when resection should be performed.…”

“…(5) is covered by visceral pleura and separated from the functioning lung, whereas intralobar pulmonary sequestration can be completely covered by normal lung tissue or by a segment of the visceral pleura of the lung lobe within which the sequestration occurs. (11)(12)(13)(14) Pulmonary sequestrations are responsible for 1.1-1.8% of all pulmonary resections. (14) In rare cases, the extralobar and intralobar forms can occur simultaneously.…”

“…(11)(12)(13)(14) Pulmonary sequestrations are responsible for 1.1-1.8% of all pulmonary resections. (14) In rare cases, the extralobar and intralobar forms can occur simultaneously. (15) The etiology of pulmonary sequestration has yet to be fully clarified.…”