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2001-08-02-12 Answer to the case of the week #55 © Izquierdo http://www.thefetus.net/

Answer to case #55

July 20-August 2,  2001

Luis A. Izquierdo, MD, RDMS; Victor H. Gonzalez-Quintero, MD; Mahsomeh Haghayegh, RDMS

Division of Maternal Fetal Medicine, University of Miami School of Medicine, PO BOX 016960 (R136), Miami, FL 33101


This 33-year-old gravida 4, para 3, was referred to our service for fetal tension hydrothorax. The gestational age was consistent with 33 weeks. An amniocentesis was performed for chromosome analysis revealing a normal male karyotype (46, XY). Polymerase Chain Reaction (PCR’s) studies were negative for Cytomegalovirus and Parvovirus.

This is a transverse view of the chest that demonstrates a large amount of pleural effusion and shifting of the mediastinum and heart to the right.

A sagittal view demonstrates the left lung in the pleural effusion.

Color Doppler demonstrates that a vessel that arises from the aorta and perfuses the left lung. 

Findings:

The important finding in this case is that the left lung is not properly perfused from the pulmonary artery but rather from an aberrant artery arising directly from the aorta. This is pathognomonic for a extralobar intrathoracic lung sequestration.

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