[Diagnosis and treatment of intralobar pulmonary sequestration].
OBJECTIVE
To summarize the diagnosis and surgical treatment of intralobar pulmonary sequestration (PS).


METHODS
The clinical data of 7 cases of intralobar PS, 5 males and 2 females, aged 15 - 38, was collected and analyzed. Macroscopic and microscopic pathological findings were recorded. The expression of protein p53 and carcinoembryonic antigen (CEA) was evaluated immunohistochemically in 6 samples obtained from lobectomy.


RESULTS
All 7 patients were admitted with major features of intermittent lung infection. Diagnosis was confirmed in all 7 cases before operation by contrast enhanced helical CT or MRI. All patients were treated with surgical excision, of which lobectomy was performed in 6 cases and wedge resection in 1 case. No surgical death was reported. All the aberrant systemic arteries arose from the thoracic aorta. The histological pictures showed polycystic lesion in sequestrated area with fibrosis formation and chronic inflammatory cell infiltration in the surrounding pulmonary stroma. Hyperplasia of epithelium occurred in some parts of the cystic lesions. Positive protein p53 staining and diffuse CEA expression were detected in all the 6 cases, showing stronger protein p53 staining in whose superficial layer of hyperplastic epithelium than in the basal layer. The normal bronchial epithelium was not stained with p53 or CEA.


CONCLUSIONS
The diagnosis of intralobar PS can be confirmed by enhanced contrast helical CT with 3-dimensional reconstruction, a non-invasive method. Surgical intervention, such as lobectomy, can be applied after complete control of pulmonary infection. Aberrant accumulation of p53 protein and CEA expression in the cystic epithelium inside PS tissues show a relationship with chronic inflammation.
Wu
Nan
N
Department of Thoracic Surgery, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing 100036, China.
Sun
Yu
Y
Zheng
Qing-Feng
QF
Lü
Chao
C
Yan
Shi
S
Zhang
Li-Jian
LJ
Yang
Yue
Y
D000293:Adolescent; D000328:Adult; D001998:Bronchopulmonary Sequestration / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery*; D002272:Carcinoembryonic Antigen / Q000096:biosynthesis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging; D008297:Male; D014057:Tomography, X-Ray Computed; D016159:Tumor Suppressor Protein p53 / Q000096:biosynthesis
D002272:Carcinoembryonic Antigen; D016159:Tumor Suppressor Protein p53