CTICasesCongenital Absence of Right Pulmonary Artery with Ipsilateral Destroyed Lung (Likely Tuberculosis)
Imaging findings
A chest radiograph shows a largely destroyed right lung with scarring and volume loss, and some scarring in the left upper lobe with tracheal displacement. CT confirms proximal interruption or congenital absence of the right pulmonary artery, with severe bronchiectasis, volume loss, and dystrophic calcifications throughout the right lung. The left lung shows some expansion, heterogeneity, and posterior/apical bronchiectasis. The right main bronchus maintains a relatively normal caliber.
Key takeaways
Congenital absence or interruption of a pulmonary artery leads to hypoperfusion of the ipsilateral lung, making it highly susceptible to recurrent infections, such as tuberculosis, which can ultimately lead to lung destruction (auto-pneumonectomy). The presence of a relatively normal-caliber bronchus in a severely volume-lost and destroyed lung suggests an acquired process, like infection, superimposed on the congenital vascular anomaly, hindering its ability to fight infection.
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