Diagnostic Challenges in a Hybrid Congenital Pulmonary Airway Malformation: A Case Report

TL;DR

A 15-year-old girl with a rare lung condition combining features of CPAM and sequestration was diagnosed using imaging techniques.

Contribution

This case report highlights the diagnostic challenges and imaging features of a rare CPAM-sequestration hybrid lesion in adolescents.

Findings

Imaging revealed a hybrid lesion combining CPAM and intralobar pulmonary sequestration in a 15-year-old female.

Contrast-enhanced CT was crucial in diagnosing the rare congenital lung malformation.

Timely surgical management is emphasized to prevent complications from these rare entities.

Abstract

Congenital pulmonary airway malformation (CPAM) and bronchopulmonary sequestration are rare congenital lung anomalies that can occasionally coexist as a “hybrid” lesion. We report a case of a 15-year-old female with a two-week history of fever with evening-predominant spikes, cough, and right hypochondrial pain. The pain was aggravated by deep inspiration and coughing. Imaging revealed a right lower lobe consolidation containing air-filled cystic spaces on chest X-ray and computed tomography (CT). An anomalous arterial supply from the descending thoracic aorta on CT angiography was also noted. These findings were diagnostic of a hybrid lesion combining features of CPAM and intralobar pulmonary sequestration. This case highlights the rarity of such CPAM-sequestration hybrid lesions and the crucial role of imaging, particularly contrast-enhanced CT, in diagnosing congenital lung malformations in adolescents presenting with atypical or non-resolving pneumonia. Awareness of these rare entities is important, as timely surgical management can prevent recurrent infections and other complications.

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