Pulmonary sequestration (extralobar)
It is usually encountered in infants, most being diagnosed before six months. It is more common in males (M:F 4:1).
Extralobar pulmonary sequestration is the less common type of pulmonary sequestration, accounting only for 15-25%.
ELS is covered by its own pleura and this is what differentiates ELS from ILS.
ELS receives vascular supply mainly from the aorta (thoracic or abdominal) or from other arterial vessels (splenic, subclavian, gastric, intercostal or multiple vessels) and venous drainage can be either systemic or pulmonary.
There is strong predilection towards the left lower lobe (65-90%).
- well marginated mass
- usually homogeneous, often without internal gas
- may contain cystic areas
- systemic arterial supply
Treatment and prognosis
Surgical excision is the mainstay of treatment.
- intralobar pulmonary sequestration: may not be able to differentiate from ELS on imaging
- bronchogenic cyst
Furthermore, in an infra-diaphragmatic location, consider :
- congenital diaphragmatic hernia
- Bronchogene Zyste
- congenital pulmonary airway malformation (CPAM)
- arteriovenöse Malformationen der Lunge
- hybrid lesion: CCAM - pulmonary sequestration
- bronchopulmonary foregut malformation (BPFM)
- intralobar pulmonary sequestration