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Weekly Chest CasesArchive of Old Cases

Case No : 689 Date 2011-01-11

  • Courtesy of Chang Hyun Lee / Seoul National University Hospital
  • Age/Sex 56 / M
  • Chief ComplaintBlood tinged sputum
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5
  • Figure 6

2010-04-20

Diagnosis With Brief Discussion

Diagnosis
Intralobar sequestration with fungus ball
Radiologic Findings
There is a 5.4cm subpleural mass in the posterobasal segment of the RLL showing central low attenuation. The mass is supplied by the vessel from the descending aorta.

Specimen after RLL lobectomy

Brief Review
Distinguishing an intrapulmonary sequestration from extrapulmonary sequestration is difficult using plain radiography. Intrapulmonary lesions tend to be heterogeneous and are not well defined. Extrapulmonary masses are usually observed as solid, well defined, and retrocardiac.
Intrapulmonary sequestrations are the most common form, and 60% of these are found in the posterior basal segment of the left lower lobe. Overall, 98% occur in the lower lobes. Bilateral involvement is uncommon. About 10% of cases may be associated with other congenital anomalies. A case of intrapulmonary sequestration associated with a bronchogenic cyst has been reported.Extrapulmonary sequestrations occur on the left in 95% of cases. Of these, 75% are found in the costophrenic sulcus on the left side. They may also be found in the mediastinum, pericardium, and within or below the diaphragm.They are associated with other congenital malformations in more than 50% of cases, such as congenital diaphragmatic hernias, congenital cystic adenomatoid malformation (CCAM) type II (hybrid lesions), and congenital heart disease.
References
Please refer to the case 214.
Keywords
Lung, Airway, Congenital, Fungal infection,

No. of Applicants : 138

▶ Correct Answer : 117/138,  84.8%
  • - SMC , Korea (South) Jihoon Cha
  • - Okayama University , Japan Akihiro Tada
  • - Chonbuk National University Hospital , Korea (South) Jisoo Song
  • - PingTung Christian Hospital ,China Medical University ,Taiwan,R.O.C. , Taiwan Jun Jun Yeh
  • - radiologist, aditya imaging centre , India vivek patel
  • - DongA University hospital , Korea (South) Jiyoung Kang
  • - Onomichi municipal hospital , Japan Junya Itakura
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - Assam Medical college , India samudra borah
  • - Hopital Louis Pradel Lyon , France Clement Proust
  • - Catholic medical center , Korea (South) hyuna kim
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - McGill University , Canada Ben Smith
  • - Univ. of Miami/Jackson Memorial , United States mantosh rattan
  • - Yokohama-asahi-chuo-general hospital , Japan Kyoko Nagai
  • - Smile Radiologic clinic , Korea (South) Sung-Kyu Choi
  • - Dongnam Institute of Radiological and Medical Sciences , Korea (South) Dae Wook Yeh
  • - CHA Bundang hospital , Korea (South) Hyerin Kim
  • - Youngdong Hospital , Korea (South) Sang Min Lee
  • - mann scan/delta scann , India max in
  • - Chonnam national university hospital , Korea (South) SeungJin Lee
  • - University of British Columbia , Canada Amr Ajlan
  • - SAISEIKAI KURIHASHI HOSPITAL , Japan YASUO OOKUBO
  • - Okayama university , Japan Takeharu Yamamoto
  • - Hangang sacred heart hospital , Korea (South) You Mie Han
  • - CH de la Ce Basque , France Paul ARDILOUZE
  • - James Paget Hospital , U.K , United Kingdom nabil mahmood
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey Meric Tuzun
  • - Doctors Hospital , Bahamas muneesh sharma
  • - Gifu Chuo Hospital , Japan Yo Kaneko
  • - Private surgery , New Caledonia Marie Benichou
  • - Virgin Mary Hospital Burgas , Bulgaria VLADISLAV RUSINOV
  • - Auckland hospital , New Zealand (Aotearoa) Yuranga Weerakkody
  • - CHU de Bordeaux , France Franis Laurent
  • - SNUH , Korea (South) Eun LEE
  • - chp st martin , France Mariotte benoit
  • - Saint Malo , France jean-baptiste Noel
  • - Kobe City Medical Center General Hospital , Japan Hitomi Nagano
  • - Deptt of Radiodiagnosis & Imaging, PGIMER chandigarh , India Ram Galwa
  • - Chonnam National University Hospital , Korea (South) Jung Hyun Kim
  • - Onomichi municipal hospital , Japan Ryotaro Kishi
  • - chonnam university hospital , Korea (South) shin hyo hyun
  • - chonnam national university , Korea (South) Byung Hyun Baek
  • - Chonnam university hospital , Korea (South) Minyoung Jung
  • - Chonnam National University Hospital , Korea (South) Daun Lee
  • - Chonnam university hospital , Korea (South) LEE JI HYUN
  • - Chonnam national univ. hospital , Korea (South) Choi Seul Gi
  • - Inha University Hospital , Korea (South) Sung Hee Park
  • - Sahyadri Speciality Hospital, Pune , India Kunal Nadgouda
  • - Department of Radiology, Chonnam National University Hospital , Korea (South) Hyungjun Kim
  • - CNUH , Korea (South) Hyedoo Jung
  • - Shree Diagnostics , India amol jagdale
  • - CNUH , Korea (South) Seoin Jeong
  • - Chonnam national university hospital , Korea (South) Yunhong Yoon
  • - Chonnam national university hospital , Korea (South) seo yeon Park
  • - Pneumology GHSR , Reunion fabrice paganin
  • - NTUH , Taiwan Kuei-pin Chung
  • - Chonnam National University , Korea (South) se hee Jung
  • - ROK air force aerospacemedical center , Korea (South) Daekeon Lim
  • - Kosin university Gospel hospital , Korea (South) Hee Kang
  • - Apollo Gleneagles hosp kolkata , India SALIM PARVEZ
  • - Vitalife Clinics , Pune , India. , India Rahul Deshmukh
  • - University of Iowa, USA , United States Archana Laroia
  • - Fukuyama daiichi Hospital , Japan Mototsugu Saeki
  • - Radnet Teleradiology , Turkey Murat Ulusoy
  • - clinique medipole toulouse , France delaunay francois
  • - Department of Diagnostic Radiology, Chonbuk National University Hospital , Korea (South) Eun Jung Choi
  • - Hotel-Dieu Montreal , Canada nicolas gautier
  • - Cairo University , Egypt Mamdouh Eissa
  • - Kasturba Medical College , India Chandan Kakkar
  • - royal melbourne hospital , Australia kimchi kings
  • - seoul national university hospital , Korea (South) Ijin Joo
  • - HSC , Brazil Diogo Pinheiro
  • - Busan Paik hospital, Inje university , Korea (South) Hye Jin Baek
  • - Severance hospital, shinchon , Korea (South) yeojin lee
  • - NDMVP Nashik , India Imran Jindani
  • - KMC,Manipal , India satish maddukuri
  • - Mallinckrodt Institute of Radiology , United States Travis Henry
  • - Inha University Hospital , Korea (South) Ju Won Lee
  • - PRINCESS MARGARET HOSPITAL , Bahamas SHUJAUDDIN RAHIMI
  • - KHOO TECK PUAT HOSPITAL , Singapore SUMER SHIKHARE
  • - Teleradiology solutions , India harish bhambore
  • - Asan medical center , Korea (South) Hyun Joo Lee
  • - Kangnam Sacred Heart Hospital , Korea (South) Jaewon Kim
  • - IRSA La Rochelle France , France Denis Chabassiere
  • - Brabois - CHU Nancy , France Alban Gervaise
  • - Osaka University , Japan Hiromitsu Sumikawa
  • - clinique de SAVOIE , France, Metropolitan gay-depassier philippe
  • - , Korea (South) 媛•
  • - Ishikawa Matto Central Hospital , Japan Manabu Akimoto
  • - HCG-MEDISURGE HOSPITAL , India PRAKASH ODEDRA
  • - korea univ. hospital, radiology department , Korea (South) choo yung
  • - All India Institute of medical sciences , India Justin Moses
  • - bmcri , India sanjeev choudri
  • - Homs National Hospital , Syria Rami Abou Zalaf
  • - All India Institute of Medical Sciences , India Ashish Gupta
  • - Seoul Nationial University Bundang Hospital , Korea (South) Hee Seok Choi
  • - Korea University Guro hospital , Korea (South) Jeon Boram
  • - NTUH, Taiwan , Taiwan Li-Ta Keng
  • - Soonchunhyang University Cheonan Hospital , Korea (South) Park Sang Hyun
  • - Iwate medical university , Japan Akio Akahane
  • - IRCCS Istituto Oncologico - Bari , Italy Carlo Florio
  • - Zaid Alsheriti hospital- Alsweida , Syria jehad alakabani
  • - Beaulieu clinic Geneva , Switzerland gilles GENIN
  • - Mallinckrodt Institute of Radiology , United States Naganathan Mani
  • - Hospital Sotiria, Athens, Greece , Greece Vasilios Tzilas
  • - Saga University , Japan Ryoko Egashira
  • - McGill University Health Center , Canada Alexandre Semionov
  • - Shree Diagnostics , India amol jagdale
  • - IRSA , France jean-luc BIGOT
  • - NASA SCANS , India RAKESH BHATIA
  • - Okayama university , Japan Mayu Uka
  • - Yonsei University College of Medicine, Shinchon Severance hospital , Korea (South) Young Joo Suh
  • - Chonnam national university hospital , Korea (South) Jang-hyeon Song
  • - Chonnam national university hosipital , Korea (South) Byung chan Lee
  • - KUMC ansan , Korea (South) kihwan kim
  • - Asan Medial center , Korea (South) Chaehun Lim
▶ Correct Answer as Differential Diagnosis : 14/138,  10.1%
  • - jaslok hospital & research centre mumbai , India JAINENDRA JAIN
  • - Toyama University Hospital, Laboratory of Pathology , Japan TOMONORI TANAKA
  • - CHU Notre-Dame Montreal , Canada Fabrice Bing
  • - KING KHALID UNIVERSITY HOSPITAL , Saudi Arabia Elbagir Nasser
  • - IGGGH & PGI , India EDWARD RAYAPPAN
  • - IRSA Rochefort , France Viviane Pages
  • - Montreal Chest Institute , Canada Faiz Kham
  • - Istanbul , Turkey Armagan Sarac
  • - Vikram hospital , India Pravin Mahadevappa
  • - Goa Medical College , India Paresh Desai
  • - aarthi scans , India abirami mahadevan
  • - Hangang Sacred Heart Hospital , Korea (South) Eil Seong Lee
  • - Medical College Chest Hospital,Thrissur,Kerala , India Raveendran TK
  • - UZ GASTHUISBERG , Belgium Johan COOLEN
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