Ghosh Subha, Fox Steven, Mehta Atul C
Thoracic Imaging, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA.
Respiratory Institute, Cleveland Clinic Foundation, Cleveland Clinic, Cleveland, OH, USA.
J Surg Case Rep. 2022 Apr 23;2022(4):rjac107. doi: 10.1093/jscr/rjac107. eCollection 2022 Apr.
A 36-year-old female with a past medical history of primary ciliary dyskinesia and bilateral lung transplantation was noted to have a rare and confounding postsurgical anatomy acquired as a result of transplantation. Bronchoscopy and computed tomography showed isomeric main bronchi with a tri-lobed right lung, a bi-lobed left lung and dextrocardia. This rare phenomenon can be observed in lung transplant recipients with situs ambiguous morphology of their native lungs, who receive donor lungs with normal situs solitus morphology. To the best of our knowledge, ours is the first reported case of such a composite bronchopulmonary situs abnormality. Careful review of bronchial anatomy should be done with the help of CT imaging prior to undertaking any bronchial interventions in these subset of patients with bronchial isomerism and bilateral lung transplantation.
一名36岁女性，既往有原发性纤毛运动障碍和双侧肺移植病史，其术后解剖结构罕见且复杂，是移植所致。支气管镜检查和计算机断层扫描显示主支气管异构，右肺三叶，左肺两叶，且有右位心。这种罕见现象可见于自身肺脏位置形态不明确的肺移植受者，他们接受的供体肺脏位置形态正常但为右位心。据我们所知，我们的病例是首例报道的这种复合性支气管肺位置异常病例。在对这些患有支气管异构和双侧肺移植的患者进行任何支气管干预之前，应借助CT成像仔细检查支气管解剖结构。
