2008 Volume 22 Issue 2 Pages 241-244
A 57-year-old man was referred to our hospital with fever. He had a history of recurrent pneumonia. Under a diagnosis of pneumonia, antibiotic treatment was administered, but an abnormal shadow on chest roentgenogram was not improved. Chest CT demonstrated a mass shadow about 6 cm in diameter in the left lower lobe, and an aberrant artery arising from the descending aorta supplying the left lower lobe. Aortography showed a systemic artery from the descending thoracic aorta supplying the mass, but venous return from the mass was not identified. A diagnosis of anomalous systemic arterial supply to the normal basal segments was established and surgery was performed. During surgical exploration, the borderline between the normal and abnormal area was not clear. Left lower lobectomy was performed with ligation and cutting of the abnormal vessel. The resected specimen demonstrated that the mass, measuring 6 cm in diameter, was a dilated systemic artery with a thrombus, supplying the left basal segment. In cases of recurrent pneumonia or showing a lack of improvement of abnormal shadows on chest roentgenogram, an anomalous systemic arterial supply to the normal basal segments must be included in the differential diagnosis, and, once the diagnosis is established, an appropriate surgical procedure based on the findings must be performed.
