Open AccessIntralobar pulmonary sequestration with cystic degeneration mimicking a bronchogenic cyst in an elderly patient
Author(s) -
Han Joon Kim,
Kyung Eun Shin,
Jai Soung Park,
Heon Lee,
Jae Woo Lee,
Susie Chin,
Hyun-Sik Shin
Publication year - 2020
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000019347
Subject(s) - medicine , bronchogenic cyst , pulmonary sequestration , radiology , magnetic resonance imaging , lung , cyst , differential diagnosis , bronchopulmonary sequestration , biopsy , pulmonary artery , surgery , pathology
Pulmonary sequestration (PS) is a rare congenital malformation defined as nonfunctioning lung tissue supplied by systemic circulation. It is uncommonly diagnosed in adults. Herein, we describe a clinical case of PS with cystic degeneration mimicking a bronchogenic cyst in an elderly patient. Patient concerns: A huge cystic mass was incidentally found in a 65-year-old man on chest computed tomography (CT) scans during preoperative workup for a hand laceration. A 15-cm-sized round cystic mass was detected in the right lower lobe. Diagnosis: After reviewing the chest CT scan, we decided to perform contrast-enhanced chest magnetic resonance imaging (MRI) and CT-guided lung aspiration biopsy. On MRI, the lesion had the appearance of a cystic mass with hemorrhagic clots, such as an intrapulmonary bronchogenic cyst. The aspirated specimen was nondiagnostic; thus, we decided to surgically remove the mass. Interventions: Upon right lower lobectomy, the mass was diagnosed as a PS. A thin systemic artery supplying the cystic mass was visualized during surgery. Outcomes: The patient is undergoing regular follow-up at the outpatient clinic. Conclusions: PS should be considered as a differential diagnosis in patients with a cystic lung mass. Identification of a systemic artery on radiologic imaging is important in the diagnosis of PS before preoperative workup to prevent unpredicted massive bleeding during surgery.