Steiropoulos P, Archontogeorgis K, Tzouvelekis A, Ntolios P, Chatzistefanou A, Bouros D
Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
Hippokratia. 2013 Jan;17(1):73-6.
Unilateral pulmonary artery agenesis (UPAA) is a rare congenital anomaly due to a malformation of the sixth aortic arch of the affected side during embryogenesis. The diagnosis is usually set at adolescence, however it can remain asymptomatic and late diagnosis is possible.
We present a case series of three female patients, aged 18, 49 and 68 years old, with history of recurrent respiratory tract infections, to whom the diagnosis of UPAA was set. They were admitted, due to hemoptysis and productive cough (case 1) or progressive dyspnea on exertion (cases 2 and 3). Chest X-ray was abnormal in all three cases, depicting shift of the mediastinal structures to the left and hypoplasia of the left lung while chest CT demonstrated absence of the left pulmonary artery.
UPAA can remain asymptomatic and diagnosis in adult age is possible, usually after an abnormal chest radiograph. A number of additional imaging techniques are available to aid the diagnosis. Physicians should consider the possibility of undiagnosed UPAA in adults.
单侧肺动脉缺如(UPAA)是一种罕见的先天性异常,由胚胎发育过程中患侧第六主动脉弓畸形引起。诊断通常在青春期确立,但也可能无症状,存在延迟诊断的可能。
我们报告了一组三例女性患者的病例系列,年龄分别为18岁、49岁和68岁,均有反复呼吸道感染史,被诊断为UPAA。她们因咯血和咳痰(病例1)或进行性劳力性呼吸困难(病例2和3)入院。三例患者的胸部X线均异常,显示纵隔结构向左移位及左肺发育不全,而胸部CT显示左肺动脉缺如。
UPAA可能无症状,成年期也可诊断,通常在胸部X线异常后。有多种额外的影像学技术可辅助诊断。医生应考虑成人未诊断出UPAA的可能性。