Shimizu Kenichiro, Masuda Kimihiko, Hebisawaa Akira, Tai Hisakazu, Kuwano Kazuyoshi
Department of Respiratory Diseases, The Jikei University Daisan Hospital.
Nihon Kokyuki Gakkai Zasshi. 2010 Mar;48(3):210-3.
A 35-year-old man visited his physician complaining of fever and a productive cough. He was referred to our hospital because of an abnormal chest X-ray film, which showed a mass-like lesion with air fluid level in the left lower lobe. He was then treated for a lung abscess with panipenem/betamipron (PAPM/BP). Anatomical abnormality was suspected because he had adverse reactions to antibiotics, and secondly the lesion was located near the left hilum. Furthermore, another abnormality of the right-sided descending aorta, was also detected by chest CT. Congenital bronchial atresia was suspected after bronchoscopy and aortic angiography. Left lower lobectomy was performed because of the anatomical abnormality and limited benefit of antibiotics. A histological specimen revealed bronchial atresia of the left B, with a bronchocele on its distal side, and pneumonia in the left S area. We report a rare case of congenital bronchial atresia with right-sided descending aorta.
一名35岁男性因发热和咳痰就诊于其医生处。因其胸部X线片异常(显示左肺下叶有一个伴有气液平面的肿块样病变),他被转诊至我院。随后他接受了帕尼培南/倍他米隆(PAPM/BP)治疗肺脓肿。怀疑存在解剖学异常,一是因为他对抗生素有不良反应,二是病变位于左肺门附近。此外,胸部CT还检测到右侧降主动脉的另一处异常。经支气管镜检查和主动脉血管造影后,怀疑为先天性支气管闭锁。由于解剖学异常以及抗生素治疗效果有限,遂行左肺下叶切除术。组织学标本显示左B支气管闭锁,其远端有一个支气管囊肿,左S区域有肺炎。我们报告了一例罕见的伴有右侧降主动脉的先天性支气管闭锁病例。