J Korean Med Sci.  2005 Dec;20(6):1070-1072. 10.3346/jkms.2005.20.6.1070.

Infected Infradiaphragmatic Retroperitoneal Extralobar Pulmonary Sequestration: A Case Report

• Kim HK
• Choi YH
• Ryu SM
• Kim HK
• Chae YS
• Sohn YS
• Kim HJ

• KMID: 2157765
• DOI: http://doi.org/10.3346/jkms.2005.20.6.1070

Abstract

Infradiaphragmatic extralobar pulmonary sequestration is an extremely rare congenital malformation. It is more frequently diagnosed in the antenatal period due to routine ultrasonic examination of the fetus or in the first 6 months of life, though on rare occasions it is discovered incidentally in adults. A 32-yr-old man presenting with epigastric discomfort and fever was referred. Computed tomographic scanning showed that a 16-cm, multiseptated, dumbbell-shaped, huge cystic tumor was located beneath the diaphragm. On the next day, 850 mL of thick yellowish pus was drained by sonography-guided fine needle aspiration for the purpose of infection control and diagnosis, but no microscopic organisms were found in repeated culture studies. Surgical removal of the cyst was performed through thoracoabdominal incision and most of these pathologic lesions were removed but we could not find the feeding arteries or any fistulous tract to surrounding structures. Histopathologic study revealed that it was extralobar pulmonary sequestration and culture study showed that many WBC and necrotic materials were found but there were no microorganisms in the cystic contents. We report the first case of an infected infradiaphragmatic retroperitoneal extralobar sequestration which was administered a staged management and achieved an excellent clinical course.

Keyword

Congenital defect; Respiratory System Abnormalities; Bronchopulmonary Sequestration; Infection, Diaphragm

MeSH Terms

Adult
Bronchopulmonary Sequestration/complications/*pathology/surgery
Diaphragm/abnormalities
Humans
Infection/complications/pathology
Male
Retroperitoneal Space/abnormalities

Figure

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  Fig. 1 Computed tomographic scan of the abdomen with contrast enhancement. A huge calcified cystic mass is located in the retroperitoneal space on the left side.

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  Fig. 2 Macroscopic appearance of the lesion. The cyst walls are thick and calcified with an irregular red inner surface.

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  Fig. 3 (A) Glandular epithelium is lined by tall columnar ciliated cells (hematoxylin-eosin stain, ×200). (B) Surfactants secreted by type II pneumocytes (arrow) (Papanicolau stain, ×200).

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