A Rare Case of Isolated Left Pulmonary Agenesis in an Adult Male Patient

Pulmonary agenesis is a rare congenital condition where there is no development of pulmonary tissue beyond the carina. One or both lungs may be involved, but bilateral involvement is not compatible with extra-uterine existence. If one lung is involved, it is most commonly the left side. However, right lung involvement is more frequently associated with other inborn anomalies and severity in presentation. Here, we report a 19-year-old male patient having complete agenesis of the left lung, presenting with recurrent episodes of nonspecific cough, without fever and dyspnea on exertion. His vitals were stable on examination, and all routine laboratory blood tests were normal. Chest auscultation revealed the absence of breath sounds in most of the left hemithorax. Chest wall movement was less compared to the right side. A chest radiograph was advised, which showed opacity in the left hemithorax, suspicious of a collapsed lung with mediastinal shift. To determine the nature of the opacity, a computed tomography (CT) scan of the chest was conducted, revealing complete agenesis of the left lung, along with ipsilateral shift of the heart and compensatory hyperinflation of the right lung. Unilateral lung agenesis may remain asymptomatic until adulthood. Radiological investigations like chest radiograph may be useful in the diagnosis, but a CT scan of the chest can confirm the diagnosis with status of the pulmonary vasculature and bronchial tree.