CTICasesExtralobar Sequestration with Phrenic Nerve Involvement
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Imaging findings
A chest radiograph showed a smooth-margined mass. CT (non-contrast) revealed a soft tissue density lesion, not particularly cystic (approximately 50 HU), with small foci of calcium, appearing continuous with the sinus and apparent septa in the periphery. Surgical resection showed the lesion originated adjacent to the phrenic fat pad near the hilum, with the phrenic nerve involved and resected. Pathology described microcystic features.
Key takeaways
This case illustrates an unusual mediastinal extralobar sequestration, emphasizing that these developmental anomalies can occur in unexpected locations. Phrenic nerve involvement is a rare but possible complication, requiring its resection and subsequent hemidiaphragm plication. While extralobar sequestrations typically have systemic arterial supply, the reported pulmonary vascular supply in this case was an interesting detail.
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