Hemoptysis in a 39-year-old smoker

Abstract

A 39-year old man, a smoker without significant medical history, presented with vague chest pain, cough, and hemoptysis. His symptoms had started 2 weeks earlier. Radiography showed an area of decreased lucency (ground glass appearance) in the right lower lobe. CT scan confirms the presence of a triangular area of inhomogeneous parenchymatous increased attenuation mainly of ground glass with inlying bronchocoeles and tree-in-bud appearance compatible with an intrapulmonary sequestration. The arterial supply is derived from the lower thoracic aorta. The venous drainage is to the left atrium. The hemoptysis is a result of a supratherapeutic International Normalized Ratio (INR) on Sintrom intake for atrial fibrillation (AF). Treatment of sequestration consisted of a thoracoscopic lobectomy.