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一名女性患者出现叶外型肺隔离症,同时伴有心包缺如和房间隔缺损。

Extralobar pulmonary sequestration with absence of pericardium and atrial septal defect in a woman.

作者信息

Tian Zhenhuan, Zhou Yuncan, Liu Hongsheng

机构信息

Department of Thoracic surgery, Peking Union Medical College Hospital, Peking Union Medical College, Dongcheng District, Beijing, 100730, China.

Peking Union Medical College, Beijing, China.

出版信息

J Cardiothorac Surg. 2019 Jun 20;14(1):113. doi: 10.1186/s13019-019-0932-9.

Abstract

BACKGROUND

Extralobar sequestration is a rare congenital malformation of lung tissue, which can be combined with other foregut and cardiac abnormalities. Our case is the first to report extralobar sequestration, absence of pericardium and atrial septal defect in the same patient.

CASE PRESENTATION

A 22-year-old female with atrial septal defect came for her recent atypical symptom of intermittent palpitation and shortness of breath. Her computed tomography showed a cystic mass located in left superior anterior mediastinum near the pulmonary trunk. With specious of cystic teratoma prior to video-assisted thoracoscopic surgery, she finally was diagnosed as extralobar sequestration, while incidentally found with congenital absence of pericardium during surgery.

CONCLUSIONS

Extralobar sequestration, absence of pericardium and atrial septal defect can occur in the same patient. The preoperative diagnostic rate of extralobar sequestration and asymptomatic absence of pericardium remains low attributed to atypical imaging features. A cardiac magnetic resonance imaging is highly recommended if necessary. Regular follow-up is essential to asymptomatic absence of pericardium and atrial septal defect patients. To patients with extralobar sequestration, an operation could be performed.

摘要

背景

肺叶外型隔离症是一种罕见的肺组织先天性畸形,可合并其他前肠和心脏异常。我们的病例是首例报告同一患者同时存在肺叶外型隔离症、心包缺如和房间隔缺损。

病例介绍

一名患有房间隔缺损的22岁女性因近期出现间歇性心悸和呼吸急促的非典型症状前来就诊。她的计算机断层扫描显示在靠近肺动脉干的左上纵隔前部有一个囊性肿块。在电视辅助胸腔镜手术前疑似为囊性畸胎瘤,最终她被诊断为肺叶外型隔离症,同时在手术中偶然发现先天性心包缺如。

结论

肺叶外型隔离症、心包缺如和房间隔缺损可发生在同一患者身上。由于影像学特征不典型,肺叶外型隔离症和无症状心包缺如的术前诊断率仍然较低。如有必要,强烈建议进行心脏磁共振成像检查。对于无症状心包缺如和房间隔缺损的患者,定期随访至关重要。对于肺叶外型隔离症患者,可以进行手术治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db7b/6585077/ff268126bdec/13019_2019_932_Fig1_HTML.jpg

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