CTICasesPseudo-Accessory Fissure with Bronchial Herniation/Hyperinflation
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Imaging findings
A smoker with known right middle lobe bronchiectasis showed a peculiar appearance in the left lung. There was a structure resembling an accessory fissure with a narrowed "waist" through which a somewhat dilated bronchus appeared to herniate. This led to a slightly hyperinflated segment of the left upper lobe, with a squeezed bronchovascular bundle.
Key takeaways
This curious finding resembles an anomalous accessory fissure trapping a portion of lung, potentially causing focal air trapping and bronchial distortion, possibly due to a localized pleura anomaly and folding.
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