Niimi T, Kajita M, Matsuyama T
Department of Thoracic Surgery, Chubu National Hospital, Aichi, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1991 Jun;39(6):935-7.
Two right pulmonary veins emptying into the left atrium is the normal state. We describe a case observed at operation in which three pulmonary veins were present on the right side and emptied into the left atrium; a third vein arised from the dorsal part of the upper lobe and followed an abnormal extrapulmonary course. Right lower lobectomy and mediastinal lymph node dissection were carried out for a 73-year-old male with lung carcinoma. At operation, an aberrant branching vein arising from the upper lobe descended dorsally to the right main bronchus and emptied into the left atrium at the middle point between carina and inferior pulmonary vein. The intermediate bronchus lay between the anomalous vein and superior pulmonary vein. Conventional tomogram, CT scan and pulmonary angiogram showed that pulmonary arteries and bronchi were normal in their pattern of branching and distribution, and that the anomalous vein observed at operation was comprised of V2a and V2b according to the system of naming on Yamashita's. Infrequent variations of pulmonary veins are to be kept in mind to that operation may be performed in safety.
两条右肺静脉汇入左心房是正常状态。我们描述了一例手术中观察到的病例，右侧有三条肺静脉汇入左心房；第三条静脉起源于上叶背侧，走行于异常的肺外路径。对一名73岁的肺癌男性患者进行了右下肺叶切除术和纵隔淋巴结清扫术。手术中，一条起源于上叶的异常分支静脉在右主支气管后方下行，在隆突与下肺静脉中点处汇入左心房。中间支气管位于异常静脉与上肺静脉之间。传统体层摄影、CT扫描和肺血管造影显示，肺动脉和支气管的分支及分布模式正常，根据山下命名系统，手术中观察到的异常静脉由V2a和V2b组成。应牢记肺静脉的罕见变异，以便安全地进行手术。
