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Intrapulmonary sequestration with arterial supply from the left internal thoracic artery: a case report
1Department of Thoracic Surgery, Fujita Health University School of Medicine, 1-98 Kutsukake, Toyoake, Aichi 470-1192, Japan.
Summary
A rare case of upper lobe pulmonary sequestration supplied by the internal thoracic artery in a young male is presented. Helical CT imaging accurately identified this unusual vascular supply, aiding diagnosis.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Diagnostic Imaging
Background:
- Pulmonary sequestration is a congenital lung malformation where lung tissue lacks normal connection with the tracheobronchial tree.
- Sequestrations are typically located in the lower lobes, and arterial supply usually originates from the descending aorta.
- Upper lobe pulmonary sequestration with systemic arterial supply from the internal thoracic artery is exceptionally rare.
Observation:
- A 20-year-old male presented with recurrent pneumonia.
- Imaging revealed an upper lobe pulmonary sequestration.
- Aberrant arteries originated from the left internal thoracic artery, supplying the sequestration and draining into the pulmonary vein.
Findings:
- Helical computed tomography (CT) with 3D reconstruction precisely delineated the aberrant arterial supply to the intrapulmonary sequestration.
- Selective intra-arterial digital subtraction angiography confirmed the left internal thoracic artery as the source of blood supply.
- Helical 3D CT provided noninvasive, accurate vascular information comparable to angiography.
Implications:
- This case highlights an extremely rare variant of pulmonary sequestration.
- Helical 3D CT is a valuable noninvasive tool for diagnosing complex vascular anomalies in pulmonary sequestration.
- Accurate pre-operative imaging is crucial for surgical planning in rare thoracic pathologies.