Pan Daniel, Cufari Maria Elena, Lim Eric
Imperial College and Academic Division of Thoracic Surgery, London, UK.
J Thorac Dis. 2014 Dec;6(12):E264-6. doi: 10.3978/j.issn.2072-1439.2014.11.12.
An asymptomatic elderly woman presented with a solitary right upper lobe mass revealed to be non-small cell lung cancer following routine surveillance post mastectomy. Upon review of CT with contrast in preparation for rigid bronchoscopy and right upper lobectomy, we noticed that the patient had a rare case of arteria lusoria. This is the presence of an aberrant right subclavian artery extending from the left side of the aortic arch, crossing posteriorly across the midline to supply the upper limb. We suggest that with a documented 100% diagnostic sensitivity on 64 multislice computed tomography, the presence of arteria lusoria within the posterior paratracheal fossa may cause life-threatening complications in the unaware during systematic lymph node dissection for non-small cell lung cancer (NSCLC).
一位无症状老年女性在乳房切除术后常规监测时发现右肺上叶有一个孤立性肿块，经检查确诊为非小细胞肺癌。在为硬质支气管镜检查和右肺上叶切除术做准备而进行增强CT复查时，我们注意到该患者患有罕见的迷走右锁骨下动脉。即异常的右锁骨下动脉从主动脉弓左侧发出，向后越过中线以供应上肢。我们认为，鉴于64排多层螺旋CT对迷走右锁骨下动脉的诊断敏感性达100%，在非小细胞肺癌系统性淋巴结清扫过程中，气管旁后隐窝内存在迷走右锁骨下动脉可能会在未察觉的情况下导致危及生命的并发症。
