Hybrid Congenital Pulmonary Malformation Revealed by Chronic Hemoptysis in a Six-Year-Old Girl: A Case Report.

Congenital lung malformations (CLMs) are developmental conditions characterized by overlapping clinical and imaging features, with hybrid lesions that combine congenital pulmonary airway malformation (CPAM) and bronchopulmonary sequestration (BPS) becoming increasingly recognized by multidetector CT (MDCT). We present the case of a six-year-old girl with a one-year history of recurrent low-volume hemoptysis. Her chest radiograph indicated a subtle opacity in the right basal area. Thoracic CT angiography revealed parenchymal consolidation in the right lower lobe, characterized by an air bronchogram that did not connect with the tracheobronchial tree and was accompanied by a well-defined thin-walled cystic lesion. This lesion was vascularized by a systemic artery originating from the anterior descending thoracic aorta and drained anomalously into the left atrium, a finding consistent with a hybrid congenital pulmonary airway malformation and sequestration. This case emphasizes the critical importance of MDCT angiography in accurately delineating parenchymal and cystic components, detecting blind-ending noncommunicating bronchi, and charting anomalous arterial supply and venous drainage, consequently differentiating hybrid CLMs from other congenital or acquired disorders and offering a vital vascular framework for surgical planning. In pediatric patients exhibiting unexplained hemoptysis or chronic focal pulmonary opacities, early CT angiography is therefore recommended to detect and accurately characterize CLMs and guide multidisciplinary management.