Radiology Case Reports (Mar 2024)

Lingular intralobar pulmonary sequestration supplied by the left inferior phrenic artery arising from the left gastric artery – A case report and literature review

  • Massupa Krisem, MD,
  • Thanyakamol Phongnarudech, MD,
  • Suthinee Hengriprasopchoke, MD,
  • Peerapat Thanapongsatorn, MD

Journal volume & issue
Vol. 19, no. 3
pp. 839 – 843

Abstract

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Pulmonary sequestration is characterized by a nonfunctional mass of lung tissue with an aberrant blood supply. Intralobar pulmonary sequestration (IPS) typically affects lower lung lobes and receives its blood supply from systemic arteries. Here, we present a unique case of a 51-year-old woman presented with recurrent nonmassive hemoptysis. Contrast-enhanced computed tomography angiography (CTA) of the chest showed uniform consolidation in the inferior lingular segment of the left upper lobe. Maximal intensity projection (MIP) and three-dimensional volume rendering (3D-VR) showed the affected area's blood supply from unusual arterial branches originating from the left inferior phrenic artery arising from the left gastric artery, consistent with IPS. A multidisciplinary approach utilized endovascular intervention (coil embolization) before successful surgical resection. Detecting IPS in unusual sites, like the lingular region, poses a diagnostic challenge. Clinicians and radiologists may not initially consider this diagnosis when evaluating patients with respiratory symptoms or incidental imaging findings. A comprehensive grasp of their anatomy and vascular variations is vital for precise diagnosis and effective treatment planning.

Keywords