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Clinical Images  |   April 2018
Bronchopulmonary Sequestration
Author Notes
  • From the Department of Radiology at the University of Florida in Gainesville (Dr Verma) and Edward Via College of Osteopathic Medicine in Spartanburg, South Carolina (Student Doctor Slater). 
  • Financial Disclosures: None reported. 
  • Support: None reported. 
  •  *Address correspondence to Nupur Verma, MD, Department of Radiology, University of Florida, PO Box 100374, Gainesville, FL 32610-0374. Email: vermnu@radiology.ufl.edu
     
Article Information
Imaging / Pediatrics / Clinical Images
Clinical Images   |   April 2018
Bronchopulmonary Sequestration
The Journal of the American Osteopathic Association, April 2018, Vol. 118, 281. doi:https://doi.org/10.7556/jaoa.2018.056
The Journal of the American Osteopathic Association, April 2018, Vol. 118, 281. doi:https://doi.org/10.7556/jaoa.2018.056
A 37-year-old man presented with shortness of breath and productive cough that started 1 week previously. The patient reported having recurrent pulmonary infection since adolescence. A computed tomographic angiograph showed left lower lobe dysplasia with large cystic areas and air-fluid level (image A, arrow). A supplying vessel from the aorta was found (image B, arrow), with venous drainage to the pulmonary vein. The patient was admitted to the hospital and given intravenous ceftriaxone (2 g) and intravenous azithromycin (500 mg every 24 hours), and he subsequently underwent segmentectomy. The patient had an unremarkable recovery without recurrence of pulmonary infection. 
Broncopulmonary sequestration is a rare congenital abnormality and may be intralobar or extralobar.1-3 In sequestration, a segment of lung parenchyma is functionally isolated and has systemic blood supply, usually from the descending aorta.2,3 Intralobar sequestration is more common than extralobar, most often occurring in the left lower lobe, and, in most cases, presents in childhood.1 Because nearly half of the patients with intralobar sequestration present after age 20 years, this diagnosis should be considered in patients with recurrent or refractory pneumonia.1,3 Lower lobe consolidation on chest radiograph with aberrant arterial supply seen on computed tomographic images assists in making the diagnosis.3 Surgical resection of the abnormal lung tissue with segmentectomy can be curative, but in cases of more extensive infection, lobectomy is necessary.3 
References
Tashtoush B, Memarpour R, Gonzalez J, et al Pulmonary sequestration: a 29 patient case series and review. J Clin Diagn Res. 2015;9(12):AC05. [PubMed]
John PR, Beasley SW, Mayne V. Pulmonary sequestration and related congenital disorders. Pediatr Radiol. 1989;20(1):4-9. [CrossRef] [PubMed]
Montjoy C, Hadique S, Graeber G, Ghamande S. Intralobar bronchopulmonary sequestration in adults over age 50: case series and review. WV Med J. 2012;108(5):8-14.