Tuberc Respir Dis TRD Tuberculosis and Respiratory Diseases 1738-3536 2005-6184 The Korean Academy of Tuberculosis and Respiratory Diseases 10.4046/trd.2010.68.6.358 Case Report Intralobar Pulmonary Sequestration Receiving Its Blood Supply from the Celiac Artery Jung Ki Hwan M.D. 1 Lee Seung Hwa M.D. 2 Lee Ju-Han M.D. 3 Jo Won Min M.D. 4 Shin Chol M.D. 1 Kim Je Hyeong M.D. 1 Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea. Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea. Department of Pathology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea. Department of Thoracic and Cardiovascular Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea. Address for correspondence: Je Hyeong Kim, M.D. Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, 516, Gojan-1-dong, Danwon-gu, Ansan 425-707, Korea. Phone: 82-31-412-5950, Fax: 82-31-413-5950, chepraxis@korea.ac.kr 06 2010 30 06 2010 68 6 358 362 16 02 2010 09 03 2010 Copyright © 2010. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved. 2010

Intralobar pulmonary sequestration is a rare congenital lung anomaly. It is defined as a portion of nonfunctioning lung parenchyma that receives its blood supply from an anomalous systemic artery. Patients often present with chronic or recurrent pneumonia. A chest radiograph may show a cystic lesion with air-fluid levels in the lung base. A high index of suspicion is needed for a diagnosis. Surgical removal of a symptomatic intralobar pulmonary sequestration is generally the treatment of choice. Identifying the aberrant artery is a difficult problem when resecting a pulmonary sequestration. The thoracic and abdominal aortas are the most common origins for the abnormal blood supply. However, arterial supply from the celiac artery is quite rare. We present a case of intralobar pulmonary sequestration with the blood supply originating from the celiac artery.

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(A) Chest radiograph on admission showed a patchy consolidation in the left lower hemithorax. (B~D) CT scan of chest revealed irregularly shaped multiloculated cystic consolidation at superior segment and posterior basal segment of left lower lobe.

(A) CT angiogram showed the prominent aberrant feeder artery arising from the celiac artery (arrow). (B) Selective angiogram revealed a large abnormal artery supplying blood to vessels within the left lower lung, and it was from the celiac artery (arrow). (C) Gross specimen of resected pulmonary sequestration showed multi-cystic and fibrotic changes. (D) Histopathologic finding of pulmonary sequestration showed the bronchiole-like structure lined by ciliated columnar epithelium and systemic arteries with concentrically arranged elastic fibers (H&E stain, ×100).