2021 Volume 35 Issue 6 Pages 718-723
A 62-year-old man was referred to our hospital because of an abnormal shadow in the right upper lung field. CT revealed the tumor measuring 18 mm in diameter in the right S1. 3D-CT on preoperative examination suggested that the right superior lobar bronchus was formed by B1a and B2a, and B1b+B2b and B3 arising from the middle lobe bronchus. Furthermore, 3D-CT showed a displaced anomalous B1b arising from the middle lobe bronchus and incomplete lobulation. He received an intraoperative rapid diagnosis of adenocarcinoma; thoracoscopic right upper and middle bilobectomy and lymphadenectomy were performed. In lung cancer surgery, we rarely encounter patients with a bronchial anomaly and the standard surgery for lung cancer with a displaced anomalous bronchus has not yet been established. 3D-CT was useful for safe operation in the case of a displaced anomalous bronchus.
