Authors: Amin Abdelsalam , Aya Doudin

Abstract

Background:
Pulmonary sequestration (PS) is a rare congenital lung anomaly in which non-functioning lung tissue receives systemic arterial supply. While typically diagnosed in childhood, adult presentation, especially of the intralobar type, remains uncommon and often challenging to recognize.

Case Presentation:
We report the case of a 46-year-old woman who presented to the emergency department with acute dry cough, dyspnea, and a single episode of hemoptysis. She had no prior history of pulmonary infections or chronic illness aside from untreated hypertension. Laboratory results were unremarkable apart from a mildly elevated D-dimer. Imaging via computed tomography angiography revealed a mass-like consolidation with systemic arterial supply from the aorta and pulmonary venous drainage, consistent with intralobar pulmonary sequestration. The patient was admitted for observation and remained clinically stable without recurrent hemoptysis or infection. She was discharged with outpatient cardiothoracic follow-up and remained asymptomatic at follow-up visits.

Conclusion:
This case highlights the importance of considering intralobar pulmonary sequestration in adults with atypical respiratory symptoms and unexplained hemoptysis. Although surgical resection is typically recommended, particularly for symptomatic cases or those with recurrent infections, our patient’s favorable course with conservative management supports the potential for individualized, non-operative strategies in selected asymptomatic adults. Further long-term data in adult populations are needed to decide optimal treatment decisions.

Keywords: Pulmonary sequestration, lung diseases, congenital, hemoptysis, dyspnea, tomography, X-ray computed angiography.