Pulmonary Intralobar Sequestration Accompanied by Aneurysm of an Anomalous Arterial Supply.

Abstract

A 47-year-old woman presented with hemoptysis and her chest X-ray films showed an opacity suggesting a mass in the left lower lung field. Based on radiographic investigations, the mass was diagnosed as an aneurysm develop in an anomalous vessel and was considered to be a Pryce type I pulmonary intralobar sequestration. Resection of the left lower lobes was performed and the aneurysm was found to be filled with thrombus. It is rare for an aneurysm to form in an aberrant vessel. This complication may have been the result of regional sclerosis affecting the anomalous artery as well as systemic atherosclerosis. (Internal Medicine 31: 946-950, 1992)

Giant aneurysmal dilation of an intralobar pulmonary sequestration artery

“…Some massive haemoptysis has also been described in intralobar sequestrations without aneurysms [2]. Although the aetiology of the haemoptysis is uncertain, we and others suspect this haemoptysis or corresponding haemothorax may be due to high-pressure flow in the sequestered lung [2,3]. Both types of sequestration receive their arterial supply through anomalous arteries from the systemic circulation.…”

“…Usually the lumen of the aberrant artery can be oversized, but it is unusual to find a true arterial aneurysm. There have only been two other cases described of intralobar sequestrations associated with an aneurysm of an aberrant artery (one in a 13-year-old boy and another in a 47-year-old female) [3][4][5][6].…”

Video-assisted thoracic resection for intralobar pulmonary sequestration

“…4,5,9 Because an anomalous artery has been exposed to systemic high blood pressure, it can result in regional atherosclerotic change and rarely in aneurysm formation. 10 Therefore, it is also important to evaluate the rigidity and thickness of the arterial wall by intraoperative manipulation with a vascular clamp before using a stapling device.…”

Aneurysm of a systemic artery supplying the normal basal segments of the left lower lobe

“…2 In three reported cases of an aneurysm of an anomalous systemic artery in this congenital lesion, lower lobectomy was carried out with resection of the aneurysm. [4][5][6] The resected aneurysms were atherosclerotic in all cases. Intimal calcification was prominent at the thoracic aorta in our case.…”

“…To our knowledge, only three cases in this condition were previously reported in the literature. [4][5][6] Case report A 78-year-old man was referred to our institution because of a mass at the left lower lobe, which was discovered on his annual checkup chest radiograph. He had no history of previous cardiopulmonary disease.…”