INTRALOBAR PULMONARY SEQUESTRATION AS A CAUSE OF RECURRENT PNEUMONIAS IN AN ADULT WOMAN: A CASE REPORT

Abstract

Introduction: Intralobar pulmonary sequestration (IPS) is an uncommon congenital malformation in adults, characterized by non-functioning lung tissue supplied by an aberrant systemic artery. Its clinical and radiologic presentation may mimic recurrent pneumonias or pulmonary neoplasms, leading to diagnostic delays. Case of report: We report the case of a 49-year-old woman with a history of asthma and insulin resistance, who had recurrent right lower lobe pneumonias since 2018. In December 2023, during the most severe episode, initial chest CT suggested a possible pulmonary neoplasm; however, a second radiologic interpretation identified a basal pseudomass with an aberrant systemic artery consistent with pulmonary sequestration. Further imaging at referral centers confirmed anomalous arterial supply from the thoracic aorta. In May 2024, a right lower lobectomy was performed via thoracotomy, revealing an intraparenchymal aberrant artery. Pathology confirmed complicated IPS with fibrosis, bronchiectasis, and chronic inflammation. Conclusion: IPS should be considered in adults presenting with recurrent pneumonias and basal lung lesions. Clinical–radiologic correlation, particularly the identification of an aberrant systemic artery, is essential for establishing the correct diagnosis and guiding definitive treatment.