Intralobar pulmonary sequestration

Abstract

Chest radiograph on admission demonstrated a small left-sided pleural effusion associated with dense retrocardiac opacification (Fig. 1). No previous radiographs were available for comparison. Repeat radiograph 6 weeks following antibiotic treatment showed partial resolution of the findings with small residual retrocardiac opacity (Fig. 2). Recurrent symptoms a year later prompted a repeat chest radiograph which demonstrated increased opacification in retrocardiac region (Fig. 3). In view of this non-resolving retrocardiac opacity a contrast enhanced CT of the thorax was performed for further evaluation. This showed a diffuse mass lesion of heterogeneous attenuation within the medial basal segment of left lower lobe of lung. This consisted of areas of enhancing soft tissue attenuation, fluid filled cystic areas and multiple areas of punctate calcification. The mass lesion manifested a systemic arterial supply via a large calibre artery arising directly from the left side of the descending thoracic aorta (Fig. 4a, b, c).