Presentation
Follow-up of incidental nodule seen on pre-op CXR.
Patient Data
Hyperinflated posterior segment of the left lower lobe supplied by arterial branches that arise directly from the descending aorta. These systemic arteries are accompanied by a short malformed blind-ending bronchus with areas of mucous plugging. The corresponding lung parenchyma is hyperinflated and hyperlucent with architectural distortion. The pulmonary veins drain predominantly into the left atrium via the left inferior pulmonary vein. A few veins drain transpleurally to the paravertebral veins. There is no pleural boundary between the abnormal segment and the adjacent normal left lung.
Well-defined 1 cm nodule in the medial segment of the right lower lobe connected to the oblique fissure and diaphragmatic pleura by septa suggesting intraparenchymal lymph node.
Case Discussion
Typical features of intralobar pulmonary sequestration as an incidental CT finding in an adult. The posterior segment of the left lower lobe is the most frequent location.
Pulmonary sequestration is a rare congenital malformation that occasionally remains asymptomatic. CT is usually sufficient for diagnosis. Complications such as recurrent pneumonia and hemoptysis are indications for surgical excision and the afferent arteries can be embolized pre-operatively 1.
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