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European Radiology
Published in: European Radiology 6/2017

01-06-2017 | Paediatric

Extralobar pulmonary sequestration in neonates: The natural course and predictive factors associated with spontaneous regression

Authors: Hee Mang Yoon, Ellen Ai-Rhan Kim, Sung-Hoon Chung, Seon-Ok Kim, Ah Young Jung, Young Ah Cho, Chong Hyun Yoon, Jin Seong Lee

Published in: European Radiology | Issue 6/2017

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Abstract

Purpose

To describe the natural course of extralobar pulmonary sequestration (EPS) and identify factors associated with spontaneous regression of EPS.

Materials and methods

We retrospectively searched for patients diagnosed with EPS on initial contrast CT scan within 1 month after birth and had a follow-up CT scan without treatment. Spontaneous regression of EPS was assessed by percentage decrease in volume (PDV) and percentage decrease in sum of the diameter of systemic feeding arteries (PDD) by comparing initial and follow-up CT scans. Clinical and CT features were analysed to determine factors associated with PDV and PDD rates.

Results

Fifty-one neonates were included. The cumulative proportions of patients reaching PDV > 50 % and PDD > 50 % were 93.0 % and 73.3 % at 4 years, respectively. Tissue attenuation was significantly associated with PDV rate (B = −21.78, P < .001). The tissue attenuation (B = −22.62, P = .001) and diameter of the largest systemic feeding arteries (B = −48.31, P = .011) were significant factors associated with PDD rate.

Conclusion

The volume and diameter of systemic feeding arteries of EPS spontaneously decreased within 4 years without treatment. EPSs showing a low tissue attenuation and small diameter of the largest systemic feeding arteries on initial contrast-enhanced CT scans were likely to regress spontaneously.

Key Points

• Extralobar pulmonary sequestration (EPS) could show spontaneous regression.
• Initial CT features may predict spontaneous regression of EPS.
• The tissue attenuation and diameter of systemic feeding artery are important factors.
Appendix
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Literature
1.
Landing BH, Dixon LG (1979) Congenital malformations and genetic disorders of the respiratory tract (larynx, trachea, bronchi, and lungs). Am Rev Respir Dis 120:151–185PubMed
2.
3.
Samuel M, Burge DM (1999) Management of antenatally diagnosed pulmonary sequestration associated with congenital cystic adenomatoid malformation. Thorax 54:701–706CrossRefPubMedPubMedCentral
4.
Van Raemdonck D, De Boeck K, Devlieger H et al (2001) Pulmonary sequestration: a comparison between pediatric and adult patients. Eur J Cardiothorac Surg 19:388–395CrossRefPubMed
5.
Hekelaar N, van Uffelen R, van Vliet AC, Varin OC, Westenend PJ (2000) Primary lymphoepithelioma-like carcinoma within an intralobular pulmonary sequestration. Eur Respir J 16:1025–1027PubMed
6.
Cho MJ, Kim DY, Kim SC, Kim KS, Kim EA, Lee BS (2012) Embolization versus surgical resection of pulmonary sequestration: clinical experiences with a thoracoscopic approach. J Pediatr Surg 47:2228–2233CrossRefPubMed
7.
Gezer S, Tastepe I, Sirmali M et al (2007) Pulmonary sequestration: a single-institutional series composed of 27 cases. J Thorac Cardiovasc Surg 133:955–959CrossRefPubMed
8.
Lee BS, Kim JT, Kim EA et al (2008) Neonatal pulmonary sequestration: clinical experience with transumbilical arterial embolization. Pediatr Pulmonol 43:404–413CrossRefPubMed
9.
Lee KH, Sung KB, Yoon HK et al (2003) Transcatheter arterial embolization of pulmonary sequestration in neonates: long-term follow-up results. J Vasc Interv Radiol 14:363–367CrossRefPubMed
10.
King SJ, Pilling DW, Walkinshaw S (1995) Fetal echogenic lung lesions: prenatal ultrasound diagnosis and outcome. Pediatr Radiol 25:208–210CrossRefPubMed
11.
Curtis MR, Mooney DP, Vaccaro TJ et al (1997) Prenatal ultrasound characterization of the suprarenal mass: distinction between neuroblastoma and subdiaphragmatic extralobar pulmonary sequestration. J Ultrasound Med 16:75–83CrossRefPubMed
12.
Garcia-Pena P, Lucaya J, Hendry GM, McAndrew PT, Duran C (1998) Spontaneous involution of pulmonary sequestration in children: a report of two cases and review of the literature. Pediatr Radiol 28:266–270CrossRefPubMed
13.
Laberge JM, Puligandla P, Flageole H (2005) Asymptomatic congenital lung malformations. Semin Pediatr Surg 14:16–33CrossRefPubMed
14.
Laberge JM, Bratu I, Flageole H (2004) The management of asymptomatic congenital lung malformations. Paediatr Respir Rev 5:S305-312
15.
Adzick NS, Harrison MR, Crombleholme TM, Flake AW, Howell LJ (1998) Fetal lung lesions: management and outcome. Am J Obstet Gynecol 179:884–889CrossRefPubMed
16.
Chowdhury M, Samuel M, Ramsay A, Constantinou J, McHugh K, Pierro A (2004) Spontaneous postnatal involution of intraabdominal pulmonary sequestration. J Pediatr Surg 39:1273–1275CrossRefPubMed
17.
Sintzoff SA Jr, Avni EF, Rocmans P, Pardou A, Struyven J (1991) Pulmonary sequestration-like anomaly presenting as a spontaneously resolving mass. Pediatr Radiol 21:143–144CrossRefPubMed
18.
Daneman A, Baunin C, Lobo E et al (1997) Disappearing suprarenal masses in fetuses and infants. Pediatr Radiol 27:675–681CrossRefPubMed
19.
Lin CH, Chuang CY, Hsia JY et al (2013) Pulmonary sequestration-differences in diagnosis and treatment in a single institution. J Chin Med Assoc 76:385–389CrossRefPubMed
20.
Rosado-de-Christenson ML, Frazier AA, Stocker JT, Templeton PA (1993) From the archives of the AFIP. Extralobar sequestration: radiologic-pathologic correlation. Radiographics 13:425–441CrossRefPubMed
21.
Lager DJ, Kuper KA, Haake GK (1991) Subdiaphragmatic extralobar pulmonary sequestration. Arch Pathol Lab Med 115:536–538PubMed
22.
Haddon MJ, Bowen A (1991) Bronchopulmonary and neurenteric forms of foregut anomalies. Imaging for diagnosis and management. Radiol Clin North Am 29:241–254PubMed
23.
Savic B, Birtel FJ, Tholen W, Funke HD, Knoche R (1979) Lung sequestration: report of seven cases and review of 540 published cases. Thorax 34:96–101CrossRefPubMedPubMedCentral
24.
25.
Kimbrell B, Degner T, Glatleider P, Applebaum H (1998) Pulmonary sequestration presenting as mitral valve insufficiency. J Pediatr Surg 33:1648–1650CrossRefPubMed
26.
Munson I, Young O, Huebsch I (2009) Fundamentals of fluid mechanics. John Wiley &Sons, Inc, New Jersey
27.
28.
Avishai V, Dolev E, Weissberg D, Zajdel L, Priel IE (1996) Extralobar sequestration presenting as massive hemothorax. Chest 109:843–845CrossRefPubMed
29.
Choe J, Goo HW (2015) Extralobar pulmonary sequestration with hemorrhagic infarction in a child: preoperative imaging diagnosis and pathological correlation. Korean J Radiol 16:662–667CrossRefPubMedPubMedCentral
30.
Chen W, Wagner L, Boyd T, Nagarajan R, Dasgupta R (2011) Extralobar pulmonary sequestration presenting with torsion: a case report and review of literature. J Pediatr Surg 46:2025–2028CrossRefPubMed
31.
Priest JR, McDermott MB, Bhatia S, Watterson J, Manivel JC, Dehner LP (1997) Pleuropulmonary blastoma: a clinicopathologic study of 50 cases. Cancer 80:147–161CrossRefPubMed
32.
MacGillivray TE, Harrison MR, Goldstein RB, Adzick NS (1993) Disappearing fetal lung lesions. J Pediatr Surg 28:1321–1324, discussion 1324-1325CrossRefPubMed
33.
Burton AC, Patel DJ (1958) Effect on pulmonary vascular resistance of inflation of the rabbit lungs. J Appl Physiol 12:239–246PubMed
34.
Duggan M, Kavanagh BP (2005) Pulmonary atelectasis: a pathogenic perioperative entity. Anesthesiology 102:838–854CrossRefPubMed
35.
Cass DL, Crombleholme TM, Howell LJ, Stafford PW, Ruchelli ED, Adzick NS (1997) Cystic lung lesions with systemic arterial blood supply: a hybrid of congenital cystic adenomatoid malformation and bronchopulmonary sequestration. J Pediatr Surg 32:986–990CrossRefPubMed
36.
Zeidan S, Gorincour G, Potier A et al (2009) Congenital lung malformation: evaluation of prenatal and postnatal radiological findings. Respirology 14:1005–1011CrossRefPubMed
37.
Zeidan S, Hery G, Lacroix F et al (2009) Intralobar sequestration associated with cystic adenomatoid malformation: diagnostic and thoracoscopic pitfalls. Surg Endosc 23:1750–1753CrossRefPubMed
38.
Carsin A, Mely L, Chrestian MA et al (2010) Association of three different congenital malformations in a same pulmonary lobe in a 5-year-old girl. Pediatr Pulmonol 45:832–835CrossRefPubMed
Metadata
Title
Extralobar pulmonary sequestration in neonates: The natural course and predictive factors associated with spontaneous regression
Authors
Hee Mang Yoon
Ellen Ai-Rhan Kim
Sung-Hoon Chung
Seon-Ok Kim
Ah Young Jung
Young Ah Cho
Chong Hyun Yoon
Jin Seong Lee
Publication date
01-06-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 6/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4594-x

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