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Joseph Junewick, MD FACR
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Sequestration

Case Detail

Anatomy: Chest
Borders
Heather Borders, MD
Diagnostic Category: Developmental or Congenital
Created: over 7 years ago
Updated: over 7 years ago
Tags: PEDS
Modality/Study Types: CT
Activities:
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History

7 day old with history of prenatally diagnosed CCAM that became less visible as the pregnancy progressed.


Case Images


Diagnosis

Left lower lobe sequestration

Findings

Left lower lobe posteromedial area of consolidation with systemic arterial supply from the aorta and drainage to the pulmonary veins compatible with an intralobar sequestration.

Discussion

Sequestration tends to occur in the medial lower lobes, left more than right. They may be small or large and may occur in conjunction with other lesions, such as CPAM.

Intralobar sequestration is the most common type of sequestration, approximately 75%. The abnormality is contained within the visceral pleura and usually presents later in life due to recurrent infection.

CT is very accurate in diagnosis. Typical findings include a homogeneous or heterogeneous lower lobe mass with systemic arterial supply. Depending on the amount of cystic change, some lesions may be categorized as hybrid lesions (i.e CPAM and sequestration). The venous drainage is key to deciding if the sequestration is intra or extra lobar (pulmonary veins=intra, systemic veins=extra).

Reference

Caffeys Pediatric Diagnostic Imaging, pp. 1299-1300.



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