Bronchopulmonary sequestration describes lung tissue (lobes or segments) without a normal connection to the remainder of the lung and with a blood supply derived from the systemic circulation, usually the aorta.
Intralobar sequestrations are most common in adults. They develop within the lung parenchyma and drain into the pulmonary venous system.
Extralobar sequestrations are most common in infants, often in association with other congenital abnormalities. They have their own visceral pleura and drain into the systemic veins.
The condition is usually asymptomatic. Recurrent pneumonia leading to infection is the major complication.
Sequestration usually occurs in the posterior basal segments of the lower lobes, more often on the left than the right.
A soft tissue mass or infiltrate is seen on x-ray when there is no communication between the bronchial tree and sequestration. A cystic air containing structure +/- a fluid level is seen if communication exists. MRI may be useful in diagnosing intralobar sequestration.
Symptomatic cases should be treated by resection. Preoperative arteriography enables the aberrant vessel to be identified. Asymptomatic cases require no intervention.
Last reviewed 01/2018