Pulmonary sequestration

Coronal maximum intensity projection (image 1) and standard projection (image 2) from contrast-enhanced CT display a systemic artery (arrow) supplying atelectatic lung tissue (arrowhead) in the right lower lobe. The atelectatic lung is also seen on chest x-ray (image 3). The systemic arterial supply to the lung is consistent with pulmonary sequestration. Pulmonary sequestrations can be intralobar or extralobar, the latter possessing a separate visceral pleura and venous drainage. Extralobar sequestration can occasionally be located below the diaphragm.

Similar cases

Frontal (image 1) and lateral (image 2) chest radiograph show innumerable small pulmonary nodules scattered throughout both lungs. These nodules are confirmed on maximum intensity projection from chest CT (image 3). Right hilar adenopathy (arrow) is also evident on chest CT (image 4). Abdominal CT (image 5) displays abnormal kidney morphology. Sarcoidosis, a multisystem granulomatous disorder, typically presents with pulmonary nodules, effusions, and hilar adenopathy. Renal involvement is rare but can manifest as granulomatous interstitial nephritis.

Chest radiograph in an infant with a congenital pulmonary airway malformation shows a bubbly lucent lesion (arrows) within the right hemithorax. The lesion crosses the midline and displaces mediastinal structures to the left. There is mild internal complexity with septations within the lesion. A congenital pulmonary airway malformation or CPAM is a developmental anomaly of the lower respiratory tract and represents the most common congenital lung lesion.

Chest x-ray shows the right lung to be smaller than the left. There is a scimitar-shaped vessel coursing from the right mid chest inferiorly. Scimitar syndrome is composed of a hypoplastic right lung, scimitar vein connecting to the inferior vena cava, and systemic arterial supply to the RLL.

Coronal contrast enhanced CT images of the chest and a patient with pulmonary sequestration shows consolidation of a portion of the left lower lobe with a systemic artery arising from the abdominal aorta and venous drainage extending to the portal vein. Pulmonary sequestration is a developmental anomaly whereby a portion of lung tissue does not connect to the bronchial tree or pulmonary arteries. It most commonly occurs in the lower lobes and is more common on the left.