Tuberc Respir Dis.  2011 Jan;70(1):79-83.

A Case of Pulmonary Sequestration Infected by Mycobacterium tuberculosis

• Shin JY
• Park HS
• Yoo SJ
• Jung SY
• Park JW
• Kim JO
• Kim SY
• Lee JE

Abstract

Pulmonary sequestration is a rare anomaly, in which a local area of a lung is supplied separately by an anomalous artery that arises from the aorta or one of its branches. Infection, mainly bacterial, is a major complication of sequestration. We report the case of a 17-year-old male patient, who presented with cough and fever. The contrast-enhanced chest computer tomomgraphy (CT) scans revealed an aberrant artery that originated from the descending thoracic aorta. He underwent a left-lower lobectomy. Macroscopically, the abnormal segment presented as multiple heterogenous cystic and solid lesions, and the cysts were filled with mucoid and pus-like material. Histology showed that the pulmonary parenchyma had been replaced by caseating epitheloid granulomas. The mycobacterial culture of his sputum was positive. On the basis of these results, the diagnosis of tuberculosis was established. The patient was treated with anti-tuberculous medication for 6 months, and 1 year later, his clinical status remained excellent.

Keyword

Mycobacterium tuberculosis; Bronchopulmonary Sequestration

MeSH Terms

Adolescent
Aorta
Aorta, Thoracic
Arteries
Bronchopulmonary Sequestration
Cough
Fever
Granuloma
Humans
Lung
Male
Mycobacterium
Mycobacterium tuberculosis
Sputum
Thorax
Tuberculosis

Figure

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  Figure 1 The initial chest X-ray showed air-space consolidation in the left lower lung field.

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  Figure 2 (A) The initial chest CT showed air-space consolidation with ground glass opacity and air-bronchogram in the left lower lung field. An air cyst was seen in the consolidation. (B) An aberrant artery supplying the left lower lobe arose from the descending thoracic aorta (arrow).

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  Figure 3 (A) The resected specimen showed a consolidated parenchyma that contained multiple heterogeneous cystic and solid lesions that were consistent with intralobar pulmonary sequestration. The cysts were filled with mucoid and pus-like material. (B) Microscopic examination of the sequestrated lung showed chronic granulomatous inflammation (H&E stain, ×100).

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