A 30-year-old woman presents with recurrent hemoptysis and dyspnea. Chest CT shows a 3 cm well-circumscribed, soft-tissue mass with intense post-contrast enhancement in the right lower lobe, supplied by a systemic artery arising from the descending thoracic aorta. Which is the most likely diagnosis?
- A Bronchogenic carcinoma
- B Pulmonary sequestration ✓
- C Pulmonary arteriovenous malformation
- D Aspergilloma
Correct answer: B. Pulmonary sequestration
Explanation
Pulmonary sequestration is characterized by non-functioning lung tissue with a systemic arterial supply, classically from the descending thoracic aorta, and intense post-contrast enhancement on CT. Bronchogenic carcinoma enhances but has a pulmonary arterial supply. Pulmonary AVM shows feeding and draining pulmonary vessels with contrast. Aspergilloma is a mobile intracavitary mass, not a solid enhancing mass with systemic supply.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
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Written and medically reviewed by the StethoPrep medical team.