Left upper division segmentectomy with a simultaneous displaced bronchus and pulmonary arteriovenous anomalies: a case r
- PDF / 1,250,226 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 1 Downloads / 191 Views
CASE REPORT
Open Access
Left upper division segmentectomy with a simultaneous displaced bronchus and pulmonary arteriovenous anomalies: a case report Kazuki Hayashi1* , Makoto Motoishi2, Kanna Horimoto3, Satoru Sawai3 and Jun Hanaoka1
Abstract Background: A displaced bronchus is a rare disorder of the left upper lobe. Displaced bronchi are often accompanied by an anomaly of a pulmonary artery, but rarely of a pulmonary vein. Case presentation: We here present a patient with primary lung cancer and simultaneous migration abnormalities of the pulmonary artery and vein in a displaced bronchus of the left upper lobe. Previous reports and our findings indicate that anomalies of the pulmonary artery and vein combined with a displaced bronchus of the left upper lobe have the following characteristics: (1) the left main pulmonary artery does not cross the dorsal side of the displaced bronchus; (2) V1 + 2 returns to the inferior pulmonary vein; and (3) there is an accessory fissure (aberrant fissure) in the segments dominated by the displaced bronchus. Conclusions: Prevention of intraoperative damage during procedures for a displaced bronchus and pulmonary arteriovenous anomalies requires careful preoperative evaluation and surgical technique with particular attention to the above-listed characteristics. Keywords: Lung cancer, Displaced bronchus, Pulmonary artery anomaly, Pulmonary venous anomaly, Accessory fissure
Background Many bronchial bifurcation abnormalities have been reported in the right upper lobe [1–3]; however, such abnormalities are rare in the left upper lobe. A displaced bronchus is frequently accompanied by the pulmonary artery taking an abnormal course [4–15], but few patients in whom the pulmonary vein also takes an abnormal course have been reported. We here report performing a segmentectomy for a left upper lobe lung cancer in a patient with a displaced bronchus in whom the left main pulmonary artery and superior pulmonary vein both took abnormal courses.
* Correspondence: [email protected] 1 Division of General Thoracic Surgery, Department of Surgery, Shiga University of Medical Science, Setatsukinowa-cho, Otsu, Shiga 520-2192, Japan Full list of author information is available at the end of the article
Case presentation A 78-year-old man was referred to our department for suspected left upper lobe lung cancer (cT1cN0M0 stage IA3). He had a history of percutaneous coronary intervention for angina pectoris, and internal carotid artery stenosis and hypertension for which he was receiving medical treatment. He had been a heavy smoker. The Brinkman Index was 1000. On chest auscultation, fine crackles were heard on the back bilaterally. Blood tests showed no abnormal findings other than a high carcinoembryonic antigen concentration (7.2 ng/mL). Pulmonary function tests showed an obstructive disorder as evidenced by a forced expiratory volume 1.0% (FEV 1.0%) (G) of 68.8%. A chest radiograph and chest computed tomography (CT) showed a tumor of maximum diameter 30 mm in the left lung S1 + 2
Data Loading...
