PMC10248170_01
CT scans of presented cases. (A) CT scan Case 1. Structural alteration in the left lower lobe with increased parenchyma opacity, no signs of ventilation (1.5 cm x 2.7 cm x 1.5 cm), extending within the diaphragm. Arrow: small diaphragmatic arterial vessel originating from the celiac trunk is visible. (B) CT scan Case 2. Solid formation in the left costo-vertebral diaphragmatic angle (2.0 cm x 2.0 cm x 1.7 cm), regular margins and no clear connection with the bronchial tree. Arrow: artery originating from the celiac trunk (4.5 mm below its aortic origin). (C) CT scan Case 3. Solid intradiafragmatic mass with regular margins (3.3 cm x 1.5 cm x 2.9 cm). Arrow: systemic arterial supply with arteries from the celiac trunk.
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PMC10248170_03_fsurg-10-1181007-g001.jpg
F1
A post-natal CT scan with contrast medium performed at 12 months of age confirmed the lesion, apparently limited to the left diaphragmatic pillar and receiving systemic blood supply from the celiac trunk, the lumbar arteries, the diaphragmatic arteries and a single small vessel from the splenic artery, thereby suggesting IDEPS (Figure 1C).
PMC10248170_02
CT scans of presented cases. (A) CT scan Case 1. Structural alteration in the left lower lobe with increased parenchyma opacity, no signs of ventilation (1.5 cm x 2.7 cm x 1.5 cm), extending within the diaphragm. Arrow: small diaphragmatic arterial vessel originating from the celiac trunk is visible. (B) CT scan Case 2. Solid formation in the left costo-vertebral diaphragmatic angle (2.0 cm x 2.0 cm x 1.7 cm), regular margins and no clear connection with the bronchial tree. Arrow: artery originating from the celiac trunk (4.5 mm below its aortic origin). (C) CT scan Case 3. Solid intradiafragmatic mass with regular margins (3.3 cm x 1.5 cm x 2.9 cm). Arrow: systemic arterial supply with arteries from the celiac trunk.
fsurg-10-1181007-g001.jpg
PMC10248170_03_fsurg-10-1181007-g001.jpg
F1
A post-natal CT scan with contrast medium performed at 12 months of age confirmed the lesion, apparently limited to the left diaphragmatic pillar and receiving systemic blood supply from the celiac trunk, the lumbar arteries, the diaphragmatic arteries and a single small vessel from the splenic artery, thereby suggesting IDEPS (Figure 1C).
PMC10248170_03
CT scans of presented cases. (A) CT scan Case 1. Structural alteration in the left lower lobe with increased parenchyma opacity, no signs of ventilation (1.5 cm x 2.7 cm x 1.5 cm), extending within the diaphragm. Arrow: small diaphragmatic arterial vessel originating from the celiac trunk is visible. (B) CT scan Case 2. Solid formation in the left costo-vertebral diaphragmatic angle (2.0 cm x 2.0 cm x 1.7 cm), regular margins and no clear connection with the bronchial tree. Arrow: artery originating from the celiac trunk (4.5 mm below its aortic origin). (C) CT scan Case 3. Solid intradiafragmatic mass with regular margins (3.3 cm x 1.5 cm x 2.9 cm). Arrow: systemic arterial supply with arteries from the celiac trunk.
fsurg-10-1181007-g001.jpg
PMC10248170_03_fsurg-10-1181007-g001.jpg
F1
A post-natal CT scan with contrast medium performed at 12 months of age confirmed the lesion, apparently limited to the left diaphragmatic pillar and receiving systemic blood supply from the celiac trunk, the lumbar arteries, the diaphragmatic arteries and a single small vessel from the splenic artery, thereby suggesting IDEPS (Figure 1C).
Toracoscopic view of IDEPS. Toracoscopic view of the IDEPS, with bulging of the diaphragm. L, lung; S, sequestration; D, diaphragm.
fsurg-10-1181007-g002.jpg
PMC10248170_03_fsurg-10-1181007-g002.jpg
F2
Therefore, a thoracoscopy was performed, highlighting a bulging of the diaphragm in the left paravertebral region (Figure 2).
(A) Histological features case 1, hematoxylin-eosin, original magnification 2X. Back-to-back cystic spaces lined by pseudostratified ciliated columnar epithelium consistent with CPAM. Asterisks: bronchioles; Arrows: aberrant vessels. (B) Histological features Case 2, Hematoxylin-eosin, original magnification 4X. Back-to-back cystic spaces lined by pseudostratified ciliated columnar epithelium consistent with CPAM. Asterisks: bronchioles; Arrows: cartilage plate. (C) Histological features Case 3, Hematoxylin-eosin, original magnification 10X. Irregularly shaped airways cystic spaces lined by pseudostratified ciliated columnar epithelium consistent with CPAM. Arrows: rhabdomyomatous dysplasia. (D) Histological features Case 3, Desmin immunostaining, original magnification 10X. Irregularly shaped airways cystic spaces lined by pseudostratified ciliated columnar epithelium consistent with CPAM. Beown staining: rhabdomyomatous dysplasia.
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F3
Indeed, they all displayed adenomatoid cystic components within nonfunctioning lung tissue supplied by one or more aberrant vessel (Figure 3).