Li Jian, Jiang Yingmei, Xiao Jiarong, Liang Guiyou
Department of Thoracic Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, China.
Guizhou Medical University, Guiyang, China.
Ann Transl Med. 2020 Aug;8(15):969. doi: 10.21037/atm-20-3815.
Extralobar pulmonary sequestration (EPS) is a congenital malformation. In contrast with intralobar sequestration, EPS located outside the normal lung tissue and with a distinct pleural covering. In the current case report, we present a rare case of EPS. To our knowledge, this is the first report of a cyst occurring within the EPS. A 17-year-old male patient presented with chest pain for 1 month. Computed tomography (CT) scan demonstrated a sharply circumscribed mass at the left side of the lower thoracic vertebrae. No aberrant vessel was observed on contrast-enhanced CT. The preoperative diagnosis was a posterior mediastinal tumor or EPS and surgical resection was recommended to the patient. During the operation, an extrapulmonary sequestration lobe was found in the left chest cavity. There was an aberrant artery connecting the sequestration lobe and the descending aorta. A cyst was located in the apex of the sequestration lobe. Surgical resection was performed via thoracoscopy. The postoperative histopathology confirmed an extrapulmonary sequestration combined with a cyst. The patient recovered successfully and was discharged on the sixth day postoperatively. He did not present with recurrent chest pain at the 6-month follow up. EPS should be considered when a posterior mediastinal conical mass is shown on chest CT.
肺叶外型肺隔离症（EPS）是一种先天性畸形。与肺叶内型肺隔离症不同，EPS位于正常肺组织之外，并有独立的胸膜覆盖。在本病例报告中，我们呈现了一例罕见的EPS病例。据我们所知，这是首例关于EPS内出现囊肿的报告。一名17岁男性患者因胸痛1个月就诊。计算机断层扫描（CT）显示下胸椎左侧有一个边界清晰的肿块。增强CT未观察到异常血管。术前诊断为后纵隔肿瘤或EPS，建议患者进行手术切除。手术中，在左胸腔发现一个肺外隔离叶。有一条异常动脉连接隔离叶和降主动脉。一个囊肿位于隔离叶的顶端。通过胸腔镜进行了手术切除。术后组织病理学证实为肺外隔离症合并囊肿。患者恢复顺利，术后第六天出院。术后6个月随访时未出现复发性胸痛。当胸部CT显示后纵隔锥形肿块时，应考虑EPS。
