Liu Xiu-Mei, Yuan Li-Mei, Wu Yu-Rui, Zhou Chun-Ju
Qilu Children's Hospital of Shandong Universities.
The Fifth People's Hospital of Jinan, Jinan, Shandong, China.
Medicine (Baltimore). 2020 May;99(20):e20052. doi: 10.1097/MD.0000000000020052.
Pulmonary sequestration (PS) is a rare pulmonary congenital malformation characterized by disconnection with the tracheobronchial tree or the pulmonary arterial blood supply thus impeding the connection to the arterial blood supply from systemic circulation, ultimately resulting in a non-functional lung.
A 73-day-old boy with rhabdomyomatoid hyperplasia was hospitalized for cough and fever 2 months after birth.
Routine B-ultrasound revealed a cystic malformation in the right lung. CT showed increased volume of the right lung accompanied with cystic low-density shadows of different sizes and a blood vessel leading from the abdominal aorta into the lesion lung. Thus, he was diagnosed with PS.
The boy underwent an entire lobectomy of the lower lobe of the right lung. The operation field revealed several malformed blood vessels from the apposition to the right lower lobe. Most of the lung had cystic adenomatoid malformations. Other parts consisted of well-differentiated cystic dilated bronchus and striated muscles. Histopathological examination revealed rhabdomyus fibroblasts distributed throughout the bronchi. Nuclei were located at the margins of the cells. Striated muscle fibers observed as immunological markers (myogenin and desmin) of striated muscles were positively detected.
The boy recovered uneventfully after his operation and no abnormal clinical findings were found at the 10-month follow-up.
PS can not only accompany other developmental abnormalities, but can also associate with rhabdomyomatoid hyperplasia. This lesion is not a fatal congenital malformation and instead is a benign lesion affecting only a single lobe. It has a relatively good prognosis.
肺隔离症(PS)是一种罕见的肺先天性畸形,其特征是与气管支气管树或肺动脉血液供应断开连接,从而阻碍了与体循环动脉血液供应的连接,最终导致肺功能丧失。
一名73天大的患有横纹肌瘤样增生的男婴在出生后2个月因咳嗽和发热住院。
常规B超显示右肺有囊性畸形。CT显示右肺体积增大,伴有大小不一的囊性低密度影,以及一条从腹主动脉通向病变肺的血管。因此,他被诊断为肺隔离症。
该男婴接受了右肺下叶全肺叶切除术。手术视野显示有几条畸形血管附着于右下叶。大部分肺有囊性腺瘤样畸形。其他部分由分化良好的囊性扩张支气管和横纹肌组成。组织病理学检查显示横纹肌成纤维细胞分布于整个支气管。细胞核位于细胞边缘。作为横纹肌免疫标志物(肌细胞生成素和结蛋白)的横纹肌纤维被阳性检测到。
该男婴术后恢复顺利,10个月随访时未发现异常临床症状。
肺隔离症不仅可伴有其他发育异常,还可与横纹肌瘤样增生相关。这种病变并非致命的先天性畸形,而是仅累及单个肺叶的良性病变。其预后相对较好。