Intralobar pulmonary sequestration presenting with hemoptysis in a 60-year-old male: a rare late adult manifestation

Pulmonary sequestration is an uncommon congenital pulmonary anomaly characterized by a mass of nonfunctional lung tissue that lacks normal communication with the tracheobronchial tree and receives its blood supply from an anomalous systemic artery. Intralobar sequestration (ILS) accounts for nearly 75% of all cases and is most often diagnosed during childhood or adolescence. Diagnosis in adulthood particularly after the fifth decade of life is very uncommon. We present the case of a 60-year-old male who presented with a long-standing productive cough, recurrent lower respiratory tract infections with recent 4–5 episodes of mild hemoptysis (5-10 ml). Radiologic evaluation with chest radiography and contrast-enhanced multidetector computed tomography (MDCT) demonstrated a hyperlucent, hyperinflated segment within the postero basal segment of left lower lobe, associated with a blind-ending mucus filled bronchus. An anomalous systemic artery arising from the descending thoracic aorta at D10 level was identified, with venous drainage into the left inferior pulmonary vein, findings which are consistent with intralobar sequestration. This case underscores the need to consider congenital pulmonary anomalies such as ILS in adult patients presenting with chronic or recurrent respiratory symptoms. It also highlights the critical role of cross-sectional imaging in ensuring accurate and timely diagnosis of this rare condition.