An adult case of extralobar pulmonary sequestration

Abstract

An adult case of extralobar pulmonary sequestration is reported. A 41-year-old female was admitted to our hospital because of an asymptomatic abnormal shadow in the left lower lobe on chest X-ray film. The serum CA19-9 was elevated (81.9 U/ml). Chest CT showed a well circumscribed tumor which was contrasted heterogeneously. Chest MRI showed an aberrant artery arising from the descending aorta. Angiography confirmed the same artery and a vein draining into the hemiazygos vein. Under the diagnosis of pulmonary sequestration, thoracotomy was performed. Two aberrant arteries were feeding the sequestrated lung clearly demarcated from adjacent lung parenchyma. Sequestrated lung was resected. The operative specimen showed abnormal lung parenchyma with large, dilated bronchioles and alveolar ducts containing inflammatory changes and abscess. Aspergillus was detected in the culture. The histology was consistent with the diagnosis of pulmonary sequestration. Immunohistochemical staining for CA19-9 was positive in the bronchial epithelium. The postoperative course was uneventful, and she was discharged on the eleventh postoperative day. The serum CA19-9 was reduced to a normal level (10.8 U/ml) on the 46th postoperative day.