Horseshoe lung associated with scimitar syndrome

Area of Science:

• Medical Imaging
• Pediatric Radiology
• Congenital Anomalies

Background:

• Horseshoe lung is a rare congenital anomaly characterized by the fusion of the posterobasal segments of both lungs.
• It is frequently associated with scimitar syndrome, a condition involving abnormal venous return.
• Early and accurate diagnosis is crucial for managing associated cardiopulmonary complications.

Observation:

• This report details two cases of horseshoe lung in infant girls.
• Both presented with right lung hypoplasia and scimitar vein, an anomalous pulmonary vein draining into the inferior vena cava.
• Associated findings included dextroposition, atrial septal defects, pulmonary stenosis, and pulmonary hypertension.

Findings:

• Chest roentgenograms revealed dextroposition and mediastinal shift.
• Echocardiography identified secundum atrial septal defects and varying degrees of pulmonary hypertension and stenosis.
• Thoracic multidetector CT (MDCT) precisely delineated the fused lung isthmus, hypoplastic right lung and pulmonary artery, and the scimitar vein.

Implications:

• Multidetector CT (MDCT) is the gold standard for demonstrating the complex anatomy of horseshoe lung and associated anomalies.
• Understanding these imaging findings is vital for pediatricians and radiologists in diagnosing and planning treatment for affected infants.
• This case series highlights the spectrum of cardiovascular abnormalities that can accompany horseshoe lung and scimitar syndrome.