Fig 1 - uploaded by Ying-Yi Chen
Content may be subject to copyright.
Chest Radiograph. Arrows show a nodular shadow at the retrocardiac region of the medial side of the left lower lobe (LLL) of the lung.
Source publication
Intralobar pulmonary sequestration is a rare congenital malformation and is often found incidentally during operation. We report a rare case of infected intralobar pulmonary sequestration clinically presenting as a bullous abscess of the lung in a 52-year-old patient. In a review of the literature on surgical cases of intralobar pulmonary sequestra...
Contexts in source publication
Context 1
... patient had infectious signs initially, such as low-grade fever, cough with copious sputum, leukocytosis and an elevated CRP value. Pulmonary infection was suspected first, based on clinical symptoms and signs. How- ever, the chest radiograph of the patient ( Figure 1) showed a nodular shadow at the retrocardiac region of the medial side of the LLL of the lung. He denied any abnormalities on previous chest radiographs (the last film was obtained 6 months prior to this admission). Chest CT showed a circumscribed homogenous mass with increased infiltration around the mass and multiple bullae of different sizes (Figure 2). Although the radiodensity of the lung mass was equal to that of soft tissue, chronic bullous ab- scess was a top priority, based on the imaging study and present illness of the patient. We con- sidered the differential diagnoses of this specific lesion at the medial side of the LLL, including solitary pulmonary mass, sequestrated lung or a posterior mediastinal tumor. Sequestrated lung had to be included in our considerations because of reported localizations at the lower lobe of the lung as high as 98.83% (848/858) [1]. Solid pulmonary tumor was relatively unlikely because of the lower tumor growth rate. Con- trast-enhanced multi-detector-row CT of the chest revealed a supply artery directly from the celiac trunk of the abdominal aorta supplying the posterior basal segment of the LLL ( Figure 3). A celiac trunk arteriography identified and confirmed the aberrant vessels (Figure 4). We diagnosed this case as an intralobar pulmonary sequestration of the LLL combined with a bul- lous abscess and an aberrant artery arising from the celiac trunk of the abdominal aorta passing through the diaphragm. Based on the above data, this patient had had bullous lung disease before, possibly caused by a significant ciga- rette smoking history [4], and the involved area of sequestrated lung was small enough that the clinical symptoms could be ignored until the emergence of a bullous abscess formation seen as a circumscribed shadow in the chest radio- ...
Context 2
... 52-year-old male complained of cough, sputum production, low back pain and low- grade fever for 1 month. He had a chest radio- graph taken at a regional hospital that showed a nodular shadow in the retrocardiac region of the medial side of the LLL of the lung ( Figure 1). He was then referred to our hospital under the impression of a solitary pulmonary mass. He had no significant medical or surgical his- tory and received regular health examinations for 10 years without abnormal findings. He was also a heavy smoker with a 20 pack-year history. Laboratory findings showed a white blood cell count of 12,200/mm 3 and C-reactive The diagnosis was an intralobar pulmonary sequestration of the LLL combined with a bul- lous abscess and an aberrant artery arising from the celiac trunk of the abdominal aorta passing through the ...