Tuberc Respir Dis.  2015 Oct;78(4):380-384. 10.4046/trd.2015.78.4.380.

Aberrant Bronchial Artery to Non-Sequestrated Left Upper Lobe in Massive Hemoptysis

• Hwang JH
• Kim EY
• Park SY

• KMID: 2320711
• DOI: http://doi.org/10.4046/trd.2015.78.4.380

Abstract

Systemic arterial supply from the descending thoracic aorta to the basal segment of the left lower lobe without a pulmonary arterial supply is a rare congenital anomaly within the spectrum of sequestration lung disease. The most common pattern of anomalous systemic artery to the lung arises from the descending thoracic aorta and feeds the basal segments of the left lower lobe. We report an extremely rare case of a 29-year-old woman who underwent a successful left upper lobectomy for the treatment of recurrent massive hemoptysis from anomalous bronchial arterial supply to the lingular segment of left upper lobe.

Keyword

Hemoptysis; Bronchopulmonary Sequestration; Bronchial Arteries

MeSH Terms

Adult
Aorta, Thoracic
Arteries
Bronchial Arteries*
Bronchopulmonary Sequestration
Female
Hemoptysis*
Humans
Lung
Lung Diseases

Figure

• 

  Figure 1 Selective bronchial angiograms reveal a hypertrophied bronchial artery (A) and vascular staining (B) in the apico-posterior segment of the left upper lobe.

• 

  Figure 2 Anomalous systemic arterial supply to normal lung parenchyma in a 29-year-old woman with recurrent hemoptysis. Multidetector computed tomographic angiography in mediastinal window settings (A-C) shows multiple nodular and curvilinear structures with high attenuation within the mediastinal soft tissue (arrows in A-C) and left upper lobe that indicate systemic arteries. In lung window settings (D-F), scans showed hypertrophied vessels in the left upper lobe and ground-glass attenuation in the left upper lobe and left lower lobe that is probably due to hyperemia from systemic supply to the lung and aspirated blood.

• 

  Figure 3 A coronal computed tomography (CT) image (A) shows aberrant bronchial artery (arrows in A) supplying the left upper lobe. After identifying aberrant bronchial artery in the CT and bronchial angiogram, bonchial artery embolization was performed to control hemoptysis in this patient. A coronal (B) and a volume-rendered CT image (C) reveal embolization coils (arrows in B and C) at the proximal portion of aberrant bronchial artery.

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