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Intralobar Sequestration
Tyler H. Ternes, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Intralobar sequestration (ILS)
              • Definitions

                • From Latin "sequestrare" (to be separated)
                • ILS (~ 75%)
                  • Shares visceral pleura of affected lobe
                • Pulmonary sequestration
                  • No normal communication with tracheobronchial tree
                  • Systemic blood supply
                • Extralobar sequestration (~ 25%)
                  • Supernumerary lung tissue
                  • Separate pleural investment when intrathoracic
                • Bronchopulmonary foregut malformation
                  • Pulmonary sequestration (extralobar sequestration or ILS) with patent foregut communication (esophagus, stomach) (rare)

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Ultrasonographic Findings

                        • Angiographic Findings

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                • Reporting Tips

                                                  Selected References

                                                  1. Alamo L et al: Revising the classification of lung sequestrations. Clin Imaging. 77:92-7, 2021
                                                  2. Gabelloni M et al: Pulmonary sequestration: what the radiologist should know. Clin Imaging. 73:61-72, 2020
                                                  3. Romberg EK et al: Applications of pediatric body CT angiography: what radiologists need to know. AJR Am J Roentgenol. 214(5):1019-30, 2020
                                                  4. Zhang N et al: Distribution, diagnosis, and treatment of pulmonary sequestration: Report of 208 cases. J Pediatr Surg. 54(7):1286-92, 2019
                                                  5. Alsumrain M et al: Pulmonary sequestration in adults: a retrospective review of resected and unresected cases. BMC Pulm Med. 18(1):97, 2018
                                                  6. Qi W et al: Intralobar pulmonary sequestration displayed as localized emphysema on computed tomography image. J Cardiothorac Surg. 12(1):83, 2017
                                                  7. Walker CM et al: The imaging spectrum of bronchopulmonary sequestration. Curr Probl Diagn Radiol. 43(3):100-14, 2014
                                                  8. Biyyam DR et al: Congenital lung abnormalities: embryologic features, prenatal diagnosis, and postnatal radiologic-pathologic correlation. Radiographics. 30(6):1721-38, 2010
                                                  9. Lee EY et al: Multidetector CT evaluation of congenital lung anomalies. Radiology. 247(3):632-48, 2008
                                                  10. Newman B: Congenital bronchopulmonary foregut malformations: concepts and controversies. Pediatr Radiol. 36(8):773-91, 2006
                                                  11. Corbett HJ et al: Pulmonary sequestration. Paediatr Respir Rev. 5(1):59-68, 2004
                                                  12. Zylak CJ et al: Developmental lung anomalies in the adult: radiologic-pathologic correlation. Radiographics. 22 Spec No:S25-43, 2002
                                                  13. Bratu I et al: The multiple facets of pulmonary sequestration. J Pediatr Surg. 36(5):784-90, 2001
                                                  14. Do KH et al: Systemic arterial supply to the lungs in adults: spiral CT findings. Radiographics. 21(2):387-402, 2001
                                                  15. Saygi A: Intralobar pulmonary sequestration. Chest. 119(3):990-2, 2001
                                                  16. Frazier AA et al: Intralobar sequestration: radiologic-pathologic correlation. Radiographics. 17(3):725-45, 1997
                                                  Related Anatomy
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                                                  Related Differential Diagnoses
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                                                  References
                                                  Tables

                                                  Tables

                                                  KEY FACTS

                                                  • Terminology

                                                    • Imaging

                                                      • Top Differential Diagnoses

                                                        • Pathology

                                                          • Clinical Issues

                                                            • Diagnostic Checklist

                                                              TERMINOLOGY

                                                              • Abbreviations

                                                                • Intralobar sequestration (ILS)
                                                              • Definitions

                                                                • From Latin "sequestrare" (to be separated)
                                                                • ILS (~ 75%)
                                                                  • Shares visceral pleura of affected lobe
                                                                • Pulmonary sequestration
                                                                  • No normal communication with tracheobronchial tree
                                                                  • Systemic blood supply
                                                                • Extralobar sequestration (~ 25%)
                                                                  • Supernumerary lung tissue
                                                                  • Separate pleural investment when intrathoracic
                                                                • Bronchopulmonary foregut malformation
                                                                  • Pulmonary sequestration (extralobar sequestration or ILS) with patent foregut communication (esophagus, stomach) (rare)

                                                              IMAGING

                                                              • General Features

                                                                • Radiographic Findings

                                                                  • CT Findings

                                                                    • MR Findings

                                                                      • Ultrasonographic Findings

                                                                        • Angiographic Findings

                                                                          • Imaging Recommendations

                                                                            DIFFERENTIAL DIAGNOSIS

                                                                              PATHOLOGY

                                                                              • General Features

                                                                                • Gross Pathologic & Surgical Features

                                                                                  • Microscopic Features

                                                                                    CLINICAL ISSUES

                                                                                    • Presentation

                                                                                      • Demographics

                                                                                        • Natural History & Prognosis

                                                                                          • Treatment

                                                                                            DIAGNOSTIC CHECKLIST

                                                                                            • Consider

                                                                                              • Image Interpretation Pearls

                                                                                                • Reporting Tips

                                                                                                  Selected References

                                                                                                  1. Alamo L et al: Revising the classification of lung sequestrations. Clin Imaging. 77:92-7, 2021
                                                                                                  2. Gabelloni M et al: Pulmonary sequestration: what the radiologist should know. Clin Imaging. 73:61-72, 2020
                                                                                                  3. Romberg EK et al: Applications of pediatric body CT angiography: what radiologists need to know. AJR Am J Roentgenol. 214(5):1019-30, 2020
                                                                                                  4. Zhang N et al: Distribution, diagnosis, and treatment of pulmonary sequestration: Report of 208 cases. J Pediatr Surg. 54(7):1286-92, 2019
                                                                                                  5. Alsumrain M et al: Pulmonary sequestration in adults: a retrospective review of resected and unresected cases. BMC Pulm Med. 18(1):97, 2018
                                                                                                  6. Qi W et al: Intralobar pulmonary sequestration displayed as localized emphysema on computed tomography image. J Cardiothorac Surg. 12(1):83, 2017
                                                                                                  7. Walker CM et al: The imaging spectrum of bronchopulmonary sequestration. Curr Probl Diagn Radiol. 43(3):100-14, 2014
                                                                                                  8. Biyyam DR et al: Congenital lung abnormalities: embryologic features, prenatal diagnosis, and postnatal radiologic-pathologic correlation. Radiographics. 30(6):1721-38, 2010
                                                                                                  9. Lee EY et al: Multidetector CT evaluation of congenital lung anomalies. Radiology. 247(3):632-48, 2008
                                                                                                  10. Newman B: Congenital bronchopulmonary foregut malformations: concepts and controversies. Pediatr Radiol. 36(8):773-91, 2006
                                                                                                  11. Corbett HJ et al: Pulmonary sequestration. Paediatr Respir Rev. 5(1):59-68, 2004
                                                                                                  12. Zylak CJ et al: Developmental lung anomalies in the adult: radiologic-pathologic correlation. Radiographics. 22 Spec No:S25-43, 2002
                                                                                                  13. Bratu I et al: The multiple facets of pulmonary sequestration. J Pediatr Surg. 36(5):784-90, 2001
                                                                                                  14. Do KH et al: Systemic arterial supply to the lungs in adults: spiral CT findings. Radiographics. 21(2):387-402, 2001
                                                                                                  15. Saygi A: Intralobar pulmonary sequestration. Chest. 119(3):990-2, 2001
                                                                                                  16. Frazier AA et al: Intralobar sequestration: radiologic-pathologic correlation. Radiographics. 17(3):725-45, 1997