Anomalous systemic arterial supply to the lung

A 51-year-old woman was presented to the emergency department with fever and cough since four days prior. On physical examination, she had coarse breath sounds in the left- lower lung. A chest radiograph showed a left-lower lung infiltrate and an abnormal shadow behind the cardiac shadow (Figure 1). She underwent computed tomography (CT) for suspected lung cancer. CT showed an infiltrate in the left-lower lobe (Figure 2) and an arterial branch from the abdominal aorta to the basal segment of the left-lower lobe (Figure 3). She was treated with amoxicillin-clavulanate for seven days. After two weeks, contrast-enhanced CT showed an aberrant artery originating from the abdominal aorta and no confined sequestrated area (Figure 4). The patient is scheduled to undergo lower lobectomy. Anomalous systemic arterial supply to the basal segments of the lung is a rare congenital anomaly and is known as Pryce type 1 sequestration.1 The recommended treatment is surgical resection or endovascular embolisation because this anomaly can cause recurrent or massive hemoptysis, congestive heart failure and pneumonia.2Figure 1: A chest radiograph shows a left-lower lung infiltrate and an abnormal shadow behind the cardiac shadow.Figure 2: A chest CT shows an infiltrate in the left-lower lobe.Figure 3: A chest CT shows an arterial branch from the abdominal aorta to the basal segment of the left-lower lobe (arrow).Figure 4: A contrast-enhanced CT shows an aberrant artery originating from the abdominal aorta (arrow).