Kawasaki Hidenori, Oshiro Yasuji, Taira Naohiro, Furugen Tomonori, Ichi Takaharu, Yohena Tomofumi, Kawabata Tsutomu
Department of Surgery, National Hospital Organization, Okinawa National Hospital, Ginowan, Okinawa, Japan.
Ann Thorac Cardiovasc Surg. 2017 Feb 20;23(1):31-35. doi: 10.5761/atcs.cr.16-00110. Epub 2016 Jun 16.
A 45-year-old man had an abnormal shadow in the right lung field on an annual screening chest X-ray. He was diagnosed with Stage IA (cT1bN0M0) lung cancer. Initially, we did not notice an anomalous vein on non-contrast computed tomography. However, we found that the right upper lobe bronchus branched from the lateral wall of the right main bronchial orifice, above the level of the common right upper lobe bronchus. Therefore, the bronchus was thought to be a tracheal bronchus. We carefully reevaluated the patient using three-dimensional computed tomography angiography. This technique showed that the anomalous right superior pulmonary vein drained into the azygos vein along the superior vena cava. These findings confirmed a partial anomalous pulmonary venous connection of the right upper lobe. We performed video-assisted thoracoscopic right upper lobectomy and mediastinal lymph node dissection for definitive treatment for lung cancer and partial anomalous pulmonary venous connection. No hemodynamic problems occurred in the postoperative course.
一名45岁男性在年度胸部X线筛查时右肺野出现异常阴影。他被诊断为IA期(cT1bN0M0)肺癌。最初,在非增强计算机断层扫描中我们未注意到异常静脉。然而,我们发现右上叶支气管从右主支气管开口的侧壁分支,高于右上叶共同支气管水平。因此,该支气管被认为是气管支气管。我们使用三维计算机断层扫描血管造影对患者进行了仔细的重新评估。这项技术显示异常的右上肺静脉沿上腔静脉汇入奇静脉。这些发现证实了右上叶部分肺静脉异位连接。我们进行了电视辅助胸腔镜右上叶切除术和纵隔淋巴结清扫术,以明确治疗肺癌和部分肺静脉异位连接。术后过程中未出现血流动力学问题。