PMC9744713_01
A 55-year-old female with left pulmonary artery sling. (A) CTA revealed an anomalous left pulmonary artery (L) originating from the proximal part of right pulmonary artery (R), coursing posterior to the main bronchus and anterior to oesophagus to reach the left hilum, resulting in slight trachea compression and airway stenosis, and the transverse diameter of the trachea was 13.13 mm at the narrowest point (black arrow). Right pulmonary artery diameter was enlarged due to the bent left pulmonary artery. (B) the maximum transverse diameter of the trachea without compression was 14.82 mm. (C) Sagittal CT images demonstrated the compressed trachea on mediastinal window. (D-F) CT showed bronchiectasis existed in each left lobe, diffuse cystic and columnar changes were observed on lung window
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Coincidently, coronary computed tomography angiography (CTA) revealed an anomalous left pulmonary artery originating from the proximal part of right pulmonary artery, coursing posterior to the trachea and anterior to oesophagus to reach the left hilum, resulting in slight trachea compression and airway stenosis, and the transverse diameter of the trachea was 13.13 mm at the narrowest point (Figure 1A), while the maximum transverse diameter of the trachea without compression was 14.82 mm (Figure 1B). The compressed trachea on the mediastinal window could also be seen on the computed tomography (CT) chest images in sagittal view (Figure 1C). The bent left pulmonary artery also caused an increase in right pulmonary artery diameter (Figure 1A). Chest CT revealed that there was bronchiectasis in each of the left lobes, including diffuse cystic and columnar abnormalities (Figure 1D-F).