Two rare cases of horseshoe lung with scimitar syndrome in Vietnam

Abstract

Horseshoe lung is a rare, congenital, pulmonary anomaly in which the caudal and basal segments of the left and right lungs are joined together. Most cases of horseshoe lung are associated with scimitar syndrome. Horseshoe lung can be diagnosed using pulmonary angiography, showing that the isthmus of the pulmonary parenchyma crosses the midline into the contralateral side. The isthmus parenchyma is typically supplied by the hypoplastic pulmonary artery. Clinical symptoms, therapeutic methods, and prognosis depend on the incidence of pulmonary hypertension, heart failure, recurrent pneumonia, and other combinations of congenital malformations. In this article, we describe two cases of horseshoe lung associated with scimitar syndrome and pulmonary malformation.

Two-stage surgical management of horseshoe lung associated with congenital pulmonary airway malformation in a neonate: A case report

“…Horseshoe lung is a rare congenital malformation characterized by the fusion of the lower lobes of both lungs, surrounding the vertebral column in a horseshoe shape. [1,5] Congenital pulmonary airway malformations is a group of abnormalities in lung tissue development, classified into five types according to Stocker's classification, with type II (described in our patient) accounting for up to 40% of cases, and worse prognosis due to its association with other congenital malformations. Congenital pulmonary airway malformations (CPAM), type II involves the cessation of bronchial tree development in the glandular stage, with the presence of multiple <2.5 cm sized cysts lined with columnar epithelium.…”

“…Horseshoe lung has been described in association with Scimitar syndrome (Table 1), making the presence of CPAM associated with horseshoe lung even rarer and challenging. [3,5,6,7] Horseshoe lung and CPAM, both, can affect respiratory system physiology, ranging from asymptomatic patients to varying degrees of respiratory distress, spontaneous pneumothorax, and recurrent infections, depending on the degree of lung involvement and location of the malformation. [2,8] Diagnosis is typically made using imaging methods such as prenatal ultrasound, postnatal X-rays, computed tomography (CT), or magnetic resonance imaging (MRI) [2], as well as pulmonary function tests and histopathological reports following surgery.…”

“…[4,9,10] Horseshoe lung, a rare malformation, has no standardized treatment and management varies between observation and surgical intervention due to potential complications related to the complex vascular and bronchial anatomy. [1,2,3,5] Our patient presented an unusual association of pulmonary malformations and due to the lack of a standardized treatment, early surgical treatment was performed in the neonatal period to avoid comorbidities associated with a bilateral procedure. Thoracotomy with lobectomy was considered a safe option.…”

Imaging spectrum of horseshoe lung: A series of four cases

“…1,14 In up to 80% of cases, HL is associated with scimitar syndrome. 1,15,16 Scimitar syndrome is characterised by a hypogenetic or hypoplastic lung with partial anomalous pulmonary venous drainage. It typically involves the right lung, with the anomalous draining vein traversing parallel to the right heart border, thus resembling a scimitar (Turkish sword) on the chest radiograph.…”

Surviving Pneumonia: A Rare Outcome of Compensatory Hyperinflation in Fibrotic Lung Disease

“…This can be caused by various conditions such as bronchiectasis, cystic fibrosis, and emphysema [4]. When a lung is severely hyperinflated, it may herniate anteriorly across the midline, leading to a horseshoe-shaped appearance on chest radiographs, which is referred to as a pseudo-horseshoe lung [5].…”