PMC4897019_01
Three-dimensional volume-rendered images with surface shading in A) sagittal and B) posterior views. The celiac artery origin of the large caliber artery is clearly seen as well its smaller caliber branch. An anomalous artery originates directly from the thoracic aorta. The anomalous systemic vein associated with the extralobar sequestration is seen originating from the sequestration (s) and draining into the incompletely filled left brachiocephalic vein (LBCV). Left inferior pulmonary vein (LIPV) is draining the intralobar sequestration.
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The lesion had anomalous systemic arterial blood supply with both pulmonary venous return and abnormal systemic venous return (Fig. 1).
Coronal maximum intensity projection (MIP) image in soft tissue window. The sequestration is seen as an abnormal enhancing soft tissue mass at the left lower lobe. The large caliber artery is arising from the abdomen. The left inferior pulmonary vein (LIPV) is seen draining the sequestration.
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The second much larger arterial vessel originated from the celiac artery, extended superiorly and penetrated the left diaphragm before reaching the center of the lesion (Fig. 2).
Coronal reformatted image with 50% overlapping slices in lung window. There is emphysematous area (E) surrounding the sequestration (s). The large caliber artery originating from the aorta and anomalous systemic vein originating from the sequestration are seen.
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The surrounding emphysematous area raised the possibility of concomitant congenital cystic adenomatoid malformation (Fig. 3).