Presentation
Hemoptysis. Cause?
Patient Data
Age: 25 years
Gender: Male
From the case:
Intralobar sequestration
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- subtle lucency of the left lower zone
- very subtle curvilinear radio-opaque retrocardiac curvilinear opacity, which is directed first inferiorly and then superiorly
From the case:
Intralobar sequestration
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- segment of hypoattenuation (gas trapping) within the posterobasal left lower lobe. This segment of lung does not appear to communicate with the bronchial tree. Solitary dilated bronchiole within this segment
- the described segment does not have its own pleural covering
- small patchy area of ground-glass at the anterior aspect of the hypoattentuating lower lobe segment
- the hypoattenuating segment is supplied by a large vascular branch arising from the descending thoracic aorta, which accounts for the subtle curvilinear opacity demonstrated on the x-ray
From the case:
Intralobar sequestration
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Volume rendered imaging showing the very large feeding vessel to the left lower sequestered segment arising from the thoracic aorta.
Case Discussion
Intralobar sequestration involving the left lower lobe with systemic arterial supply of the sequestered segment from the descending thoracic aorta.
This case is interesting as the patient presented with hemoptysis (unusual as the sequestered segment should not technically communicate with bronchial tree). There have been case reports of hemoptysis as the main presenting complaint 1. The small region of ground-glass lung parenchymal attenuation may represent hemorrhage in this setting.
This patient underwent surgical excision as is the mainstay of treatment.