A Rare Case of Horseshoe Lung Presenting in Adulthood and Associated With a Pulmonary Sling

Abstract

Horseshoe lung is a rare congenital malformation in which the pulmonary parenchyma connects in the midline posterior to the pericardium and anterior to the aorta and esophagus. There have been 51 case reports in the world literature. About 80% of these have been associated with Scimitar syndrome, and most cases are diagnosed in infancy due to pulmonary symptoms. To our knowledge, this is the first case report of horseshoe lung presenting in an adult and associated with a pulmonary sling, complete bowel malrotation, and renal ectopia.

Elevated Carbohydrate Antigen 19-9 Level in a Patient with Horseshoe Type Pulmonary Sequestration

“…The lung parenchyme isthmus are generally part of more hypoplastic side of the bilateral lung segments. The pleural layers are hard to be distinguished on high resolution CT [4]. …”

Horseshoe Lung Associated with Left Lung Hypoplasia: Case Report and Systematic Review of the Literature

“…It was reported that 80% of cases of HL involving typical right lung hypoplasia also involved scimitar syndrome, which is a subtype of partial anomalous pulmonary venous connection (PAPVC) in which the abnormal right pulmonary vein drains into the inferior vena cava [ 19 , 20 ]. Scimitar syndrome usually occurs on the right side.…”

“…The indications for surgery include recurrent infections, severe left-to-right shunts (a pulmonary (Qp)/systemic (Qs) blood flow ratio (Qp/Qs) of >2:1,) in the presence of progressive pulmonary hypertension, and cardiovascular malformations [ 10 ]. MDCT is useful for detecting cardiovascular malformations such as anomalies of the pulmonary vein or PAPVC [ 3 , 20 ] and for aiding decision-making regarding the optimal treatment strategy for HL. In our case, ASD and VSD were depicted using 128-slice DSCT and a high-pitch spiral acquisition sequence ( Figure 4 ).…”

False appearance of bilateral pneumothorax in a patient with hypoplastic left lung

“…Congenital cases are usually diagnosed during early childhood and are generally associated with Scimitar syndrome. 2 A similar congenital condition called horseshoe lung (posterior mediastinal fusion of the lower lobes) can be diagnosed during infancy or adulthood. 1,2 Hypoplasia of one lung and compensatory hyperinflation of the contralateral lung is usually the result of chronic inflammatory lung disease causing pulmonary hypoplasia.…”

“…Most patients described in the literature are newborns and infants. 1,2 Chronic infections in childhood can also cause lung hypoplasia. We present a patient with left lung hypoplasia and right lung hyperinflation that was diagnosed after a condition mimicking bilateral pneumothorax.…”