title: Atherosclerosis of aberrant arteries from the left gastric artery into the right intralobar pulmonary sequestration complicated by mycobacterial epithelioid cell granuloma.
abstract: Vascular changes observed in intralobar pulmonary sequestration (PS) have been reported to be similar to those observed in pulmonary hypertension (PH). However, atherosclerosis in the pulmonary artery, which is one of the characteristic arterial changes of PH, has scarcely been reported in PS. Here, we report this unique manifestation in a 66-year-old man, in whom an intralobar PS fed by an aberrant artery branching from the left gastric artery had been identified 10 years earlier, and who was diagnosed with pneumonia after having symptoms of fever and cough. He was treated by lobectomy of the lower lobe of his right lung. Subsequently, a culture test of the fluid from the sequestrated lung was performed, which identified Mycobacterium avium. Subsequent pathological examination of the sequestrated lung demonstrated multiple epithelioid cell granulomas. Furthermore, atherosclerosis of the aberrant artery was also found, which may be associated with his advanced age. This is an extremely rare case of right intralobar PS supplied by aberrant artery with atherosclerosis originating from left gastric artery passing over the diaphragm.
authors: Department of Diagnostic Pathology, NTT Medical Center Tokyo, Tokyo, Japan. Electronic address: hhashimoto-tki@umin.ac.jp.
authors: Hirotsugu
authors: H
authors: Hashimoto
authors: Department of General Thoracic Surgery, NTT Medical Center Tokyo, Tokyo, Japan.
authors: Masahiro
authors: M
authors: Yanagiya
authors: Department of Radiology, NTT Medical Center Tokyo, Tokyo, Japan.
authors: Masashi
authors: M
authors: Kusakabe
authors: Department of Molecular Pathology, Tokyo Medical University, Tokyo, Japan.
authors: Atsushi
authors: A
authors: Kurata
authors: Department of Respiratory Medicine, NTT Medical Center Tokyo, Tokyo, Japan.
authors: Sayaka
authors: S
authors: Ohara
authors: Department of Diagnostic Pathology, NTT Medical Center Tokyo, Tokyo, Japan; Department of Pathology, Asahi General Hospital, Chiba, Japan.
authors: Yoshio
authors: Y
authors: Suzuki
authors: Department of General Thoracic Surgery, NTT Medical Center Tokyo, Tokyo, Japan.
authors: Jun
authors: J
authors: Matsumoto
authors: Department of Diagnostic Pathology, NTT Medical Center Tokyo, Tokyo, Japan.
authors: Hajime
authors: H
authors: Horiuchi
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000382:microbiology / Q000473:pathology*; D001998:Bronchopulmonary Sequestration / Q000382:microbiology / Q000473:pathology*; D015622:Epithelioid Cells / Q000473:pathology; D006099:Granuloma / Q000382:microbiology / Q000473:pathology; D006801:Humans; D008297:Male; D015270:Mycobacterium avium-intracellulare Infection / Q000150:complications*; D011651:Pulmonary Artery / Q000473:pathology*
keywords: Atherosclerosis; Epithelioid cell granuloma; Left gastric artery; Mycobacterium avium; Pulmonary hypertension; Pulmonary sequestration