A rare cause of intrathorasic mass in an asymptomatic child

Pulmoner sekestrasyon trakeobronşiyal ağaçla ilişkisi olmayan ve kan akımını pulmoner arterler yerine anormal bir sistemik arterden sağlayan, fonksiyon göstermeyen primitif dokudan oluşmuş, nadir görülen, genellikle kistik bir kitledir. İntralober pulmoner sekestrasyon genellikle geç çocukluk çağı veya erişkin çağda hasta enfeksiyon ile başvurduğunda tanınır. Ekstralober pulmoner sekestrasyonlu hastaların çoğu infant döneminde solunum sıkıntısı ve kronik öksürük ile başvurur. Burada, timpanostomi tüpü yerleştirilmek üzere rutin preoperatif tetkikler yapılırken akciğer filminde tesadüfen ekstralober pulmoner sekestrasyon saptanan dokuz yaşındaki bir kız olguyu sunduk.

Asemptomatik bir çocuktaki nadir bir intratorasik kitle nedeni

Pulmonary sequestration is an uncommon usually cystic mass of nonfunctioning primitive tissue that does not communicate with the tracheobronchial tree that receives it’s blood supply from an anomalous systemic artery rather than the pulmonary arteries. Intralobar pulmonary sequestration is usually diagnosed later in childhood or adulthood when the patient presents with pulmonary infection. Many patients with extralobar pulmonary sequestration present during infancy with pulmonary respiratory distress and chronic cough. Here, we reported a case of extralobar pulmonary sequestration found coincidentally on chest radiograph in a nine year old girl during routine preoperative investigations for insertion of tympanostomy tube.

Kaynakça

1. Kravitz RM. Congenital malformations of the lung. Pediatr Clin North Am 1994; 41: 453-472.

2. Corbett HJ, Humphrey GM. Pulmonary sequestration. Paediatr Respir Rev 2004; 5: 59-68.

3. 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: 96-101.

4. Halkic N, Cuenoud PF, Corthesy ME, et al. Pulmonary sequestration: a review of 26 cases. Eur J Cardiothorac Surg. 1998; 14: 127-133.

5. Clements BS, Warner JO. Pulmonary sequestrations and related bronchopulmonary-vascular malformations: no-menclature and classification bases on anatomical and embryological considerations. Thorax 1987;42: 401–408.

6. Langston C. New concepts in the pathology of congenital lung malformations. Semin Paediatr Surg 2003;12:17–37.

7. Krummel TM. Congenital malformations of the lower respiratory tract. In: Chernick V, Boat TF, Kendig EL, editors. Kendig’s Disorders of the Respiratory Tract In Children. 6th ed. Philadelphia: WB Saunders Company; 1998; 287-328.

8. Stocker JT. Sequestrations of the lung. Semin Diagn Pathol 1986; 3: 106-121.

9. Avishai V, Dolev E, Weissberg D, Zajdel L, Priel IE. Extralobar sequestration presenting a massive hemothorax. Chest 1996; 109: 843-845.

10. Cukier A, Kavakama J, Teixeira LR, Terra-Filho M, Vargas FS. Scimitar sign with normal pulmonary venous drainage and systemic arterial supply. Chest 1994; 105: 294-295.

11. John PR, Beasley SW, Mayne V. Pulmonary sequestration and related congenital disorders. A clinico-radiological review of 41 cases. Pediatr Radiol 1989; 20: 4-9.

12. Ko SF, Ng SH, Lee TY, et al. Noninvasive imaging of bronchopulmonary sequestration. AJR Am J Roentgenol 2000; 17: 1005-1012.

13. Ikezoe J, Murayama S, Godwin JD, Done SL, Verschakelen JA. Bronchopulmonary sequestration: CT assestment. Radiology 1990; 176: 375-379.

14. Kouchi K, Yoshida H, Matsunaga T, et al. Intralobar bronchopulmonary sequestration evaluated by contrastenhanced three-dimensional MR angiography. Pediatr Radiol 2000; 30: 774-775.

15. Morin L, Crombleholme TM, D'Alton ME. Prenatal diagnosis and management of fetal thoracic lesions. Semin Perinatol 1994; 18: 228-253.

16. Bratu I, Flageole H, Chen MF, Di Lorenzo M, Yazbeck S, Laberge JM. The multiple facets of pulmonary sequestration. J Pediatr Surg 2001; 36: 784-790.

17. Adzick NS, Harrison MR, Crombleholme TM, Flake AW, Howell LJ. Fetal lung lesions: Management and outcome. Am J Obstet Gynecol 1998; 179: 884-889.

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