A 43-year-old white woman had an asymptomatic left lower lobe density on a chest roentgenogram. She had a past history of biopsy-proven sarcoidosis in 1984 that resolved without corticosteroids. A midsystolic click was heard on cardiac examination. Computed tomography (CT) revealed an extralobar pulmonary sequestration in the left base. Rapid sequence CT scanning revealed an arterial supply from the thoracic aorta and venous return to the inferior vena cava. A pleural lining and cystic parenchymal changes were also seen. After a discussion of the risks and benefits of surgical resection, the patient elected only clinical follow-up.
