CTICasesTracheal Bronchus, Bilobed Right Lung, and Left Lung Hypoplasia
Imaging findings
CT of the chest demonstrates a smaller left hemithorax with a hypoplastic, hyperlucent left lung and a narrow left main bronchus showing anomalous branching. The right lung is bilobed due to the complete absence of the horizontal fissure. A large tracheal bronchus arises from the lateral wall of the trachea above the carina to supply the apical segment of the right upper lobe, while a separate, low-takeoff right upper lobe bronchus originates from the bronchus intermedius to supply the anterior and posterior segments.
Key takeaways
Congenital tracheobronchial anomalies often coexist with lobation abnormalities and lung hypoplasia. When a tracheal bronchus is present, the anatomical right upper lobe bronchus is frequently displaced inferiorly along the main airway, and the normal horizontal fissure may be absent, leading to a bilobed right lung configuration that can remain asymptomatic and unrecognized into late adulthood.
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