Mao Kaiyi, Wang Leibo, Mao Yuchen, Shang Xianhui, Zhou Guangxu, Zhao Peng, Wang Cao, Ma Hong
Department of Pediatric Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, China.
Department of Pediatric Surgery, Guizhou Children's Hospital, Zunyi, China.
Front Med (Lausanne). 2024 Nov 11;11:1455978. doi: 10.3389/fmed.2024.1455978. eCollection 2024.
This paper reports a rare case of extralobar pulmonary sequestration in the posterior mediastinum of a neonate with arterial supply from the pulmonary artery. A 3-day-old male neonate was diagnosed with type II congenital pulmonary airway malformation after prenatal color Doppler ultrasonography showed a lesion with blood supply from the pulmonary artery in the left lung. Post-birth chest computed tomography(CT) showed that the lesion was located in the posterior mediastinum with low density change, mild stripe enhancement after contrast, and no obvious blood supply vessels. A neurogenic tumor was considered for the preoperative diagnosis. The mass was removed by video-assisted thoracoscopic surgery. During the surgery, the mass was observed to be a dark red solid lump with a feeding vessel originating from the pulmonary artery. The postoperative histopathological diagnosis was extralobar pulmonary sequestration. Combined with the preoperative imaging results, it was considered that the nourishing vessels might have intermittent torsion. The patient recovered well after surgery, and no recurrence was observed after 6 months of follow-up. Therefore, the possibility of extralobar pulmonary sequestration cannot be ruled out for posterior mediastinal masses that are not supplied by the descending aorta or without identified feeding vessels.
本文报道了1例罕见的新生儿后纵隔肺叶外型肺隔离症，其动脉血供来自肺动脉。1名3日龄男性新生儿，产前彩色多普勒超声检查显示左肺有1个由肺动脉供血的病变，诊断为II型先天性肺气道畸形。出生后胸部计算机断层扫描（CT）显示病变位于后纵隔，呈低密度改变，增强扫描后有轻度条纹状强化，未见明显供血血管。术前诊断考虑为神经源性肿瘤。通过电视辅助胸腔镜手术切除肿块。术中观察到肿块为暗红色实性肿块，有1条来自肺动脉的供血血管。术后组织病理学诊断为肺叶外型肺隔离症。结合术前影像学结果，考虑滋养血管可能存在间歇性扭转。患者术后恢复良好，随访6个月未见复发。因此，对于后纵隔肿块，如果不是由降主动脉供血或未发现供血血管，不能排除肺叶外型肺隔离症的可能。
