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Pulmonary sequestration with haemoptysis and an unsuspected carcinoid tumour
Authors:Kai Nowak  Jan von der Thüsen  Wolfram Karenovics  Simon Padley  Michael Dusmet
Affiliation:1. Department of Thoracic Surgery, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
4. Division of Surgical Oncology and Thoracic Surgery, Mannheim University Medical Center, University of Heidelberg, Heidelberg, Germany
2. Department of Pathology, Royal Brompton Hospital, London, UK
3. Department of Radiology, Royal Brompton Hospital, London, UK
Abstract:We report the case of a fit and healthy 41-year-old man, who presented with significant haemoptysis without a history of recurrent infections. His computed tomography scan showed a dense lesion in the left lower lobe with a feeding vessel arising from the abdominal aorta, characteristic for an intra-pulmonary sequestration. To prevent possible further haemoptysis or infections, a left lower lobectomy was performed. The histological examination showed the typical features of a sequestration. However, within the sequestration, a carcinoid tumour without atypical features was found. There was no lymph node involvement. Sequestrations are congenital lesions without communication with the bronchial tree and with a systemic blood supply. They commonly cause recurrent infection. Fatal haemoptysis has also been described, but is rare. There are very few reports of neoplastic lesions in sequestrations. This case illustrates two unusual aspects of sequestrations. Surgery offers definitive treatment for both pathologies, as opposed to embolisation.
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