Published online May 26, 2023. doi: 10.12998/wjcc.v11.i15.3658
Peer-review started: March 6, 2023
First decision: March 24, 2023
Revised: March 26, 2023
Accepted: April 17, 2023
Article in press: April 17, 2023
Published online: May 26, 2023
Pulmonary sequestrations often lead to serious complications such as infections, tuberculosis, fatal hemoptysis, cardiovascular problems, and even malignant degeneration, but it is rarely documented with medium and large vessel vasculi
A 44-year-old man with a history of acute Stanford type A aortic dissection status post-reconstructive surgery five years ago. The contrast-enhanced computed tomography of the chest at that time had also revealed an intralobar pulmonary sequestration in the left lower lung region, and the angiography also presented perivascular changes with mild mural thickening and wall enhancement, which indicated mild vasculitis. The intralobar pulmonary sequestration in the left lower lung region was long-term unprocessed, which was probably associated with his intermittent chest tightness since no specific medical findings were detected but only positive sputum culture with mycobacterium avium-intracellular complex and Aspergillus. We performed uniportal video-assisted thoracoscopic surgery with wedge resection of the left lower lung. Hypervascularity over the parietal pleura, engorgement of the bronchus due to a moderate amount of mucus, and firm adhesion of the lesion to the thoracic aorta were histopathologically noticed.
We hypothesized that a long-term pulmonary sequestration-related bacterial or fungal infection can result in focal infectious aortitis gradually, which may threateningly aggravate the formation of aortic dissection.
Core Tip: We present a case of a 44-year-old man with history of acute Stanford type A aortic dissection status post reconstructive surgery five years ago. An intralobar pulmonary sequestration in the left lower lung region was also noticed accidently, but without further management at that time. Since symptoms of chest tightness bothered him in recent one year, he came to Thoracic surgery outpatient department where slowly growing of the lung lesion was noticed. Admission was suggested for resection of the left lower lung.