Congenital Pulmonary Airway Malformation with Sequestration - Hybrid Lesion - Presenting as a Non-Resolving Pneumonia: A Case Report with Radiological Review.

Congenital lesions of lung are rare, with overall incidence of 1/10000 to 1/25000 births (2.2 % as compared to acquired lesions). CPAM and BPS are the commoner lesions. Hybrid lesion (coexistent CPAM and BPS) are extremely rare. Diagnosis can be made antenatally in-utero or postnatally due to complications of the lesion, such as recurrent pneumonias, lung abscesses and pneumothorax. We report a case of a 4 year old male child presenting with recurrent pneumonia. Chest radiograph showed dense consolidation in the left lower zone and multiple small air filled cystic spaces in the left mid and lower zones, few showing air-fluid levels. HRCT showed dense consolidation in the left lower lobe with air-bronchogram and small air-filled cavities. Contrast study showed two arterial feeders arising from descending thoracic aorta with venous drainage into left inferior lobe pulmonary vein. A diagnosis of lung sequestration with associated CCAM was made.