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Left Pre-hyparterial Accessory Bronchus

Imaging findings

High-resolution CT images demonstrate an accessory bronchus arising from the left main bronchus or the origin of the left upper lobe bronchus. The anomalous airway is situated beneath the left pulmonary artery, placing it in a hyparterial location. It appears to represent a pre-hyparterial accessory bronchus supplying a portion of the left upper lobe, possibly corresponding to an accessory apical segment.

Key takeaways

An accessory bronchus on the left is a rare congenital tracheobronchial anomaly. While right-sided tracheal bronchi are more common, left-sided anomalous bronchi typically arise from the main bronchus rather than the trachea itself and are often pre-hyparterial. They are usually incidental findings but can be associated with localized fissure anomalies or airway clearance issues.

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