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Intralobar pulmonary sequestration coexisting with pulmonary cryptococcosis: A case report and literature review

  • Authors:
    • Dan Cheng
    • Yue Wang
    • Jun Li
    • Dan Yu
    • Yunyun Wang
    • Jinbo Fan
    • Jiankun Wang
    • Liqun He
  • View Affiliations / Copyright

    Affiliations: Department of Blood Transfusion Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China, Clinical Molecular Diagnosis Center, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China, Department of Laboratory, Clinical Molecular Diagnostics Center, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China, Department of Pathology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China, Department of Thoracic Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China, Department of Pulmonary and Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China, Department of Nephrology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
    Copyright: © Cheng et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 78
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    Published online on: January 23, 2026
       https://doi.org/10.3892/etm.2026.13073
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Abstract

Pulmonary sequestration (PS) is a rare congenital foregut abnormality characterized by non‑functioning lung tissue that receives an arterial blood supply from an anomalous systemic artery, typically the aorta, and is separated from the normal tracheobronchial tree. It often presents as a mass‑like, cystic, cavitary or pneumonic lesion on imaging. Patients often present with symptoms of recurrent pulmonary infection; however, cryptococcal infection is rare. The present case study reports on a 52‑year‑old man with PS and cryptococcal infection. The mass in the lower lobe of the right lung was removed by video‑assisted thoracoscopic surgery and diagnosed as PS. Furthermore, the nodule present in the left inferior lobe was identified as cryptococcal infection by percutaneous lung biopsy. Pulmonary cryptococcosis (PC) disappeared after antifungal treatment. During the 3‑year follow‑up, the patient was in good condition and no recurrence of either disease was observed on contrast‑enhanced CT. The present unique case of intralobar PS with a contralateral PC nodule underscores that in the absence of a classic systemic feeding artery on imaging, percutaneous biopsy is a key step in diagnosing PS and excluding malignancy. This demonstrates the necessity for anatomy‑driven management strategies, whereby spatially separated pathologies warrant a combined approach of surgical resection for the PS and targeted antifungal therapy for the PC. The definitive exclusion of cryptococcal infection within the resected PS tissue argues for a coincidental coexistence in this immunocompetent host, highlighting the importance of evaluating each lesion independently rather than seeking a unifying diagnosis in complex pulmonary presentations.

View Figures

Figure 1

Contrast-enhanced CT before and after
treatment. (A) The axial contrast-enhanced CT image shows an oval
lesion in the right lower lobe (red arrow). Careful evaluation of
the CT scan, including this image and the full series, did not
definitively demonstrate a systemic arterial supply to the lesion.
A nodule in the left lower lobe (yellow arrow) is also observed.
(B) Follow-up contrast-enhanced CT scan after surgery shows the
post-resection change in the right lower lobe (red arrow) and
resolution of the left lower lobe nodule (yellow arrow).

Figure 2

Histopathological findings of nodules
in the posterior basal segment of the left lower lobe of the lung.
(A) Granulomatous inflammation with multinucleated giant cells
containing a number of round and oval cryptococcal yeasts (H&E
staining; yellow arrow; scale bar, 50 µm). (B) Periodic acid-Schiff
positive staining (red arrow; scale bar, 50 µm). (C) Silver
hexamethonium positive staining (green arrow). (D) Organisms
positive for mucicarmine (yellow arrow; scale bar, 50 µm;
magnification, x200).

Figure 3

Gross appearance of operative
specimen. Macroscopically, the size of the resected right lung lobe
was 17x11x3 cm and a capsule with a size of 3.5x3x1.5 cm was
observed in the section 3.5 cm from the broken end of the bronchus.
The contents of the capsule were lost and the wall thickness was
0.1-0.2 cm. Within the section, the remaining (non-sequestered)
lung tissue of the resected lobe appeared soft and gray-red (scale
bar, 1 cm).

Figure 4

Histopathologically, the resected
specimen contained dilated cystic cavities of different sizes
(yellow arrow) and some of the cyst walls were covered with
pseudostratified ciliated columnar epithelium (green arrow). The
alveolar septa were widened, with hyperplasia of interstitial
fibrous tissue (blue arrow) and increased lymphocyte infiltration,
hemorrhage, cystic change and histocyte aggregation (red arrow).
(A) Original magnification, x100 (scale bar, 50 µm); (B) original
magnification, x200 (scale bar, 50 µm; H&E staining).
View References

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Copy and paste a formatted citation
Spandidos Publications style
Cheng D, Wang Y, Li J, Yu D, Wang Y, Fan J, Wang J and He L: <p>Intralobar pulmonary sequestration coexisting with pulmonary cryptococcosis: A case report and literature review</p>. Exp Ther Med 31: 78, 2026.
APA
Cheng, D., Wang, Y., Li, J., Yu, D., Wang, Y., Fan, J. ... He, L. (2026). <p>Intralobar pulmonary sequestration coexisting with pulmonary cryptococcosis: A case report and literature review</p>. Experimental and Therapeutic Medicine, 31, 78. https://doi.org/10.3892/etm.2026.13073
MLA
Cheng, D., Wang, Y., Li, J., Yu, D., Wang, Y., Fan, J., Wang, J., He, L."<p>Intralobar pulmonary sequestration coexisting with pulmonary cryptococcosis: A case report and literature review</p>". Experimental and Therapeutic Medicine 31.3 (2026): 78.
Chicago
Cheng, D., Wang, Y., Li, J., Yu, D., Wang, Y., Fan, J., Wang, J., He, L."<p>Intralobar pulmonary sequestration coexisting with pulmonary cryptococcosis: A case report and literature review</p>". Experimental and Therapeutic Medicine 31, no. 3 (2026): 78. https://doi.org/10.3892/etm.2026.13073
Copy and paste a formatted citation
x
Spandidos Publications style
Cheng D, Wang Y, Li J, Yu D, Wang Y, Fan J, Wang J and He L: <p>Intralobar pulmonary sequestration coexisting with pulmonary cryptococcosis: A case report and literature review</p>. Exp Ther Med 31: 78, 2026.
APA
Cheng, D., Wang, Y., Li, J., Yu, D., Wang, Y., Fan, J. ... He, L. (2026). <p>Intralobar pulmonary sequestration coexisting with pulmonary cryptococcosis: A case report and literature review</p>. Experimental and Therapeutic Medicine, 31, 78. https://doi.org/10.3892/etm.2026.13073
MLA
Cheng, D., Wang, Y., Li, J., Yu, D., Wang, Y., Fan, J., Wang, J., He, L."<p>Intralobar pulmonary sequestration coexisting with pulmonary cryptococcosis: A case report and literature review</p>". Experimental and Therapeutic Medicine 31.3 (2026): 78.
Chicago
Cheng, D., Wang, Y., Li, J., Yu, D., Wang, Y., Fan, J., Wang, J., He, L."<p>Intralobar pulmonary sequestration coexisting with pulmonary cryptococcosis: A case report and literature review</p>". Experimental and Therapeutic Medicine 31, no. 3 (2026): 78. https://doi.org/10.3892/etm.2026.13073
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