Elevated Leukocytes Combined with Left Lung Consolidation on Chest Computed Tomography (CT) Scan in an Adult Patient Firstly Misdiagnosed as Pneumonia and Finally Diagnosed as Pulmonary Sequestration by Enhanced CT Scan and CT Angiography: a Case Report and Literature Review
| Autor: | Yi Chen, Qian C Chen, Pei Min, Yang Lu, Wen Q Li, Qian Zhang, Lin L Hou, Ye Sun, Qin Jing, Hai F Zhang, Xiao Y Zhu, Shuang Zhang, Yan L Ge, Jia B Zhang, Li Q Li, Yang Liu |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Aortography Computed Tomography Angiography General Biochemistry Genetics and Molecular Biology Diagnosis Differential Pulmonary sequestration Pulmonary consolidation Bronchoscopy Leukocytes medicine Humans Bronchopulmonary Sequestration Diagnostic Errors Lung medicine.diagnostic_test business.industry Mediastinum Pneumonia Middle Aged medicine.disease medicine.anatomical_structure Maximum intensity projection Angiography Female Radiology medicine.symptom Tomography X-Ray Computed business |
| Zdroj: | Clinical Laboratory. 66 |
| ISSN: | 1433-6510 |
| Popis: | Background Pulmonary sequestration is an uncommon pulmonary disorder. We presented an adult case with recurrent pulmonary infection firstly misdiagnosed as pneumonia, which proved as pulmonary sequestration by enhanced CT scan and CT angiography. Methods Appropriate laboratory tests, chest CT scan, bronchoscopy, and CT angiography were performed for diagnosis. Results The white blood cells detected by routine blood test were 11.8 x 109/L, the plain chest CT scan showed the volume of the lower lobe of the left lung decreased and the density increased. Enhanced CT and maximum intensity projection (MIP) algorithms were used for three-dimensional (3D) reconstruction of the images: no abnormally enhanced shadows were seen in the reduced lower lobe of the left lung, and tortuous vascular shadows were seen in the mediastinum. Bronchoscopy showed a narrowing of the opening in the dorsal segment of the lower lobe of the left lung. Thoracic aortography revealed an abnormal arterial supply to the lower left lung, the pathological results of thoracoscopic resection of the lower left lung were pulmonary sequestration. Conclusions Pulmonary consolidation may be more than a simple pulmonary infection. Physicians should consider the possibility of pulmonary sequestration in patients with recurrent or refractory pneumonia. Enhanced CT findings of abnormal blood vessel supply are helpful for pulmonary sequestration diagnosis, and CT angiography is the gold standard for diagnosis. |
| Databáze: | OpenAIRE |
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