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    Go to the top of the page   ID: 20030119101312 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Lung sequestrum, extralobular
    M Paetzel. Lung sequestrum, extralobular. PedRad [serial online] vol 3, no. 1.
    URL: www.PedRad.info/?search=20030119101312


     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    M. Paetzel (Cleveland/USA)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    11 Months  

     
     Pediatric Radiology CasesGender:

    N/A  

     
     Pediatric Radiology CasesRegion-Organ:

    Thorax-Lung  

     
     Pediatric Radiology CasesMost likely etiology:

    congenital  

     
     Pediatric Radiology CasesHistory:

    11 month-old child. In the course of a feverish infection, an x-ray was obtained. This showed a segmental opacity in the lower right lobe. After a 10 day antiobiotic treatment, the x-ray was unaffected. Clinical presentations of an infection were no longer to be seen. No increase of the CRP.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    Deformity: bronchopulmonary tissue has no connection to the bronchial system. The vasculature is always atypical via an artery of the systemic circulation.

    Intralobular form: artery of the aorta, venous return into a lung vein (left-to-left shunt).
    Air can penetrate through a Kohn pore.

    Extralobular form: additional lung segment with its own pleura. The venous return occurs via an extrapulmonary vein (in this case: azygos vein, left-to-right shunt). Characteristically, this is located to the left, basally.  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: a.p.: Triangular (segmental) opacity in the lower field. This sits directly on the diaphragm.




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Lateral: Triangular (segmental) opacity in the lower field. This sits directly on the diaphragm.




     MRI <- view MRI

    MRI 1: MR-Angiography (Contrast, T1-weighted GE-Sequence): Triangular signal intensive lesion just above the diapragm (green arrow) is shown. Atypical vessel supply of the abdominal aorta is shown (red arrow). The venous supply is through the azygos vein.

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Imaging including endoscopy  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    After the proof of abnormal veins: none. Without the proper MRI diagnostics, the probable differentials would be:

    Pneumonia, Atelektasis, thracic placed spleen or kidney, tumor of unknown origin  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    The child is furthermore without clinical symptoms.

    In general, a surgery is recommenden, since the sequester could become inflamed. A left-right shunt could also be considered, but in this case, it would not have been sufficient.

    If pulmonary sequesters can be treated by embolisation of the particular artery is still under scrutiny. If a reader has experience with this treatment, I would be highly interested in information regarding it.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    Lung seqester, extralobular, segmental, opacity, lower field, left, extralobular lung sequestrum, extralobular lung sequester, respiratory infection, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    M Paetzel. Lung sequestrum, extralobular. PedRad [serial online] vol 3, no. 1.
    URL: www.PedRad.info/?search=20030119101312  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: Thorax-Lung
    or in the region: Thorax
    or in the tissue/organ: Lung
    or with the etiology: congenital
     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     
    Lung sequestrum, extralobular
    M Paetzel. Lung sequestrum, extralobular. PedRad [serial online] vol 3, no. 1.
    URL: www.PedRad.info/?search=20030119101312


     

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    Lung sequestrum, extralobular
    Other cases by these authors:

    Search M. Paetzel in Medline M. Paetzel (10)   

    Lung sequestrum, extralobular  
     
    Lung sequestrum, extralobular
    M Paetzel. Lung sequestrum, extralobular. PedRad [serial online] vol 3, no. 1.
    URL: www.PedRad.info/?search=20030119101312


     

    Which diagnosis have other collegues guessed?


    • segmental pneumonia
      Votes: 1 (3 %)


    • bronchial pneumonia
      Votes: 1 (3 %)


    • atypical pneumonia
      Votes: 2 (7 %)


    • lung sequester
      Votes: 16 (61 %)


    • thoracic spleen
      Votes: 4 (15 %)


    • atelektasis
      Votes: 2 (7 %)



        Total answers: 26

     
    Lung sequestrum, extralobular
    M Paetzel. Lung sequestrum, extralobular. PedRad [serial online] vol 3, no. 1.
    URL: www.PedRad.info/?search=20030119101312


     

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    Lung sequestrum, extralobular
    M Paetzel. Lung sequestrum, extralobular. PedRad [serial online] vol 3, no. 1.
    URL: www.PedRad.info/?search=20030119101312


     




    Discussion >> Write Comment <<


    Lungensequester, extralobulär :  Lungensequester
    (Anita Zücker | 22.04.09)


    Vor zwei Jahren wurde bei zufällig ein Lungensequester entdeckt. Dieser wurde operativ entfernt. Nun ist meine Frage, ob ein Lungensequester vererbbar ist. Ich bin in der 13.SSW und mache mir darüber Gedanken.
    Vielen Dank im Vorraus.
    Viele Grüße Anita Zücker.



    Röntgen: Lungensequester, extralobulär
    (Waibel Peter | 05.06.05)


    Ich sehe auf dem Bild den venösen Abstrom eher in Richtung Lungenvenen. Gibt es weitere Bilder?
    Ist die V. hemiazygos nicht mitbeteiligt?








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