Hirata M, Gima M, Yoneda S, Kajita Y, Fujita Y, Shiota K, Ii Y, Tanimukai S, Nakaji K, Miyauchi T
Division of Internal Medicine, Nantan General Hospital, Kyoto, Japan.
Nihon Kokyuki Gakkai Zasshi. 1998 Oct;36(10):875-80.
A 50-year-old woman was examined because of chest discomfort. Chest X-ray films disclosed a tumorous shadow behind the heart. Chest computed tomography (CT) scans revealed a mass connected to the descending aorta, with increased blood flow in the left basal segment. The patient was admitted for further examination. Chest CT scans and cardioscintigrams were very useful as diagnostic tools, but the final diagnosis was made on the basis of angiography. An anomalous tortuous artery ran from the descending aorta into the left basal segment and returned to the left inferior pulmonary vein. The left pulmonary arterial trunk had no basal branch (A8-A10). A loop corresponding to the superior vein (V6) ran beneath the anomalous tortuous artery. To our knowledge, this is the second case of Pryce type-I interlobar pulmonary sequestration with anomalous return to the left inferior pulmonary vein to be reported in Japan. A left inferior lobectomy was performed. Histological finding from the excised tissues showed prominent interstitial fibrosis, atypical adenomatous hyperplasia, and atherosclerosis. Following surgery, the patient's PaO2 increased from 80.4 Torr to 95.8 Torr, suggesting that left inferior lobectomy was an appropriate treatment.
一名50岁女性因胸部不适接受检查。胸部X线片显示心脏后方有肿瘤阴影。胸部计算机断层扫描(CT)显示一个与降主动脉相连的肿块,左肺基底段血流增加。患者入院进一步检查。胸部CT扫描和心脏闪烁扫描作为诊断工具非常有用,但最终诊断是基于血管造影做出的。一条异常迂曲的动脉从降主动脉延伸至左肺基底段,然后回流至左下肺静脉。左肺动脉主干没有基底分支(A8 - A10)。一条与上叶静脉(V6)相对应的静脉袢走行于异常迂曲动脉下方。据我们所知,这是日本报道的第二例普赖斯I型叶间肺隔离症伴左下肺静脉异常回流的病例。行左下肺叶切除术。切除组织的组织学检查显示有明显的间质纤维化、非典型腺瘤样增生和动脉粥样硬化。手术后,患者的动脉血氧分压从80.4托升至95.8托,表明左下肺叶切除术是一种合适的治疗方法。