Intralobar sequestration presenting as a large intrapulmonary hematoma and massive hemothorax

Area of Science:

• Pulmonology
• Radiology
• Thoracic Surgery

Background:

• Intralobar sequestration is a congenital lung malformation characterized by abnormal lung tissue supplied by systemic arteries.
• It is typically diagnosed due to recurrent respiratory infections like pneumonia, cough, or expectoration.

Observation:

• A 27-year-old male presented with massive hemoptysis, a rare initial symptom for intralobar sequestration.
• Chest computed tomography (CT) revealed a large intrapulmonary hematoma and extensive hemothorax.

Findings:

• The imaging findings mimicked a ruptured benign lung tumor with pleural effusion.
• The diagnosis of intralobar sequestration was confirmed, despite the atypical presentation.

Implications:

• Clinicians should consider intralobar sequestration in the differential diagnosis of hemoptysis, especially when accompanied by cystic lung lesions and hemothorax on CT.
• Early recognition and appropriate management are crucial to prevent life-threatening complications such as massive hemorrhage.