Diagnostic Challenges in a Hybrid Congenital Pulmonary Airway Malformation: A Case Report

Congenital pulmonary airway malformation (CPAM) and bronchopulmonary sequestration are rare congenital lung anomalies that can occasionally coexist as a "hybrid" lesion. We report a case of a 15-year-old female with a two-week history of fever with evening-predominant spikes, cough, and right hypochondrial pain. The pain was aggravated by deep inspiration and coughing. Imaging revealed a right lower lobe consolidation containing air-filled cystic spaces on chest X-ray and computed tomography (CT). An anomalous arterial supply from the descending thoracic aorta on CT angiography was also noted. These findings were diagnostic of a hybrid lesion combining features of CPAM and intralobar pulmonary sequestration. This case highlights the rarity of such CPAM-sequestration hybrid lesions and the crucial role of imaging, particularly contrast-enhanced CT, in diagnosing congenital lung malformations in adolescents presenting with atypical or non-resolving pneumonia. Awareness of these rare entities is important, as timely surgical management can prevent recurrent infections and other complications.