Adult Intralobar Pulmonary Sequestration: A Report of Two Cases With Distinct Clinical Presentations

Adult pulmonary sequestration (PS) is an uncommon congenital lung anomaly that may present with nonspecific respiratory symptoms and misleading radiological findings. We report two adult cases of intralobar pulmonary sequestration with distinct clinical presentations. The first case involved a 54-year-old diabetic smoker admitted for recurrent bronchopulmonary infections and severe recurrent hemoptysis requiring blood transfusions. Thoracic computed tomography (CT) angiography revealed a hypervascular lesion in the left lower lobe supplied by aberrant systemic vessels arising from the descending thoracic aorta. Surgical resection was performed and resulted in a favorable outcome. The second case involved a 61-year-old man with a persistent chronic cough resistant to antibiotic therapy. Because the lesion initially raised suspicion of malignancy, CT-guided lung biopsy was performed before the vascular nature of the lesion was recognized, resulting in hemoptysis. Further CT angiography identified an aberrant systemic arterial supply, establishing the diagnosis of intralobar pulmonary sequestration, and the patient subsequently underwent successful surgical resection. These cases illustrate how pulmonary sequestration in adults may mimic infection or malignancy, highlighting the critical role of CT angiography in diagnosis and pretherapeutic evaluation, particularly to avoid potentially hazardous invasive procedures.