Wakahara Tomoyuki, Kaji Masahide, Sato Shunsuke, Hamabe Yutaka
Department of Surgery, Yodogawa Christian Hospital, 2-9-26 Awaji, Osaka 533-0032, Japan.
Surg Today. 2006;36(5):470-3. doi: 10.1007/s00595-005-3176-3.
Thoracic isomerism, or symmetric morphology, is frequently associated with cardiac and abdominal anomalies. We report an unusual case of isolated left thoracic isomerism with lung cancer. A 67-year-old woman was referred to our hospital for investigation of an abnormal shadow on a chest X-ray. Chest computed tomography (CT) showed bilateral hyparterial bronchi, and bronchofiberscopy showed bifurcation of the right main bronchus into two branches. Pulmonary arteriography subsequently revealed that the right pulmonary artery bifurcated at the hilum and that it was not a mirror image of the left pulmonary artery. No other malformations were found on echocardiography or abdominal CT scan. We performed segmental resection of right S(1+2) and S(3) for lung cancer and the patient had an uneventful postoperative course. It is important to clarify the anatomy of patients with thoracic isomerism before surgical manipulation.
胸段异构，即形态对称，常与心脏和腹部异常相关。我们报告一例罕见的孤立性左胸段异构合并肺癌的病例。一名67岁女性因胸部X线检查发现异常阴影而转诊至我院。胸部计算机断层扫描（CT）显示双侧动脉下支气管，支气管纤维镜检查显示右主支气管分为两个分支。随后的肺动脉造影显示右肺动脉在肺门处分叉，且并非左肺动脉的镜像。超声心动图或腹部CT扫描未发现其他畸形。我们对肺癌患者进行了右肺S(1+2)和S(3)段切除术，患者术后恢复顺利。在手术操作前明确胸段异构患者的解剖结构很重要。
