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Case of the Month – April

By Solokara Karunarathne

History:

47 year old male patient attending for routine follow up of colonic adenocarcinoma after treatment.

Imaging:

CT Chest  – post contrast study. Key findings include air trapping in right lower lobe with mucous plugging in abnormal bronchi medial basal segment. Abnormal artery is noted supplying the lung segment directly from descending thoracic aorta. Venous drainage is likely via pulmonary veins.

Diagnosis:

Intralobar pulmonary sequestration.

Discussion:

Sequestraton is a bronchopulmonary foregut malformation with no blood supply from pulmonary arteries and without communication to bronchial tree. Most are intralobar with direct arterial supply from aorta, as in this case.

Almost all cases are sporadic. Some cases can regress spontaneously and usual treatment is surgical resection, with coil embolisation being used in selective cases.

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