J Korean Soc Radiol.  2017 May;76(5):369-373. 10.3348/jksr.2017.76.5.369.

Isolated Unilateral Pulmonary Artery Hypoplasia with Accompanying Pulmonary Parenchymal Findings on CT: A Case Report

• Park S
• Cha YK
• Kim JS
• Kwon JH
• Jeong YJ
• Kim SJ

• KMID: 2377042
• DOI: http://doi.org/10.3348/jksr.2017.76.5.369

Abstract

Unilateral pulmonary artery hypoplasia or agenesis without congenital cardiovascular anomalies is rare in adults. We report a case of a 36-year-old man with isolated left unilateral pulmonary artery hypoplasia with recurrent hemoptysis. On computed tomography (CT), the left pulmonary artery showed hypoplasia with multiple collateral vessels seen in the mediastinum and the left hemithorax. Also, parenchymal bands and peripheral linear opacities were seen in the affected lung, which were probably due to chronic infarction induced by unilateral pulmonary artery hypoplasia. There are only a few reports focusing on the radiologic findings in the pulmonary parenchyma induced by unilateral pulmonary artery hypoplasia, such as parenchymal bands and peripheral linear opacities. Therefore we report this case, which focused on the CT findings in the pulmonary parenchyma due to isolated unilateral pulmonary artery hypoplasia.

MeSH Terms

Adult
Hemoptysis
Humans
Infarction
Lung
Mediastinum
Multidetector Computed Tomography
Pulmonary Artery*

Figure

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  Fig. 1 Isolated unilateral pulmonary artery hypoplasia in a 36-year-old man who presented with hemoptysis. A. PA chest radiograph shows a small left hilum (arrow) compared to the right hilum. The left hemidiaphragm is slightly elevated, but mediastinal structures are not displaced. B-E. On chest CT with lung setting (B), parenchymal bands are seen in the posterolateral portion of the left lower lobe (arrow). Mediastinal setting of chest CT (C, D) shows serrated pleural thickening in the left posterolateral portion of the hemithorax (arrow). Tortuous prominent collateral vessels are noted in the mediastinum (arrows, arrowhead). Maximum intensity projection image (E) shows a hypoplastic left pulmonary artery (arrow). F-I. Pulmonary angiography (F, G) shows a small left pulmonary artery (arrows), compared to the right pulmonary artery. Left subclavian angiography (H) shows fine systemic collateral vessels (arrow) that supply the left lung. Left intercostal angiography (I) shows collateral branches of the left intercostal artery (arrow) with abnormal lung parenchymal staining. CT = computed tomography J. The lung perfusion scan shows a near total perfusion defect (arrows) in the left lung.

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