Left anomalous systemic arterial supply to normal basal segments with irreversible vascular degeneration

Abstract

There are few reports of pathological evidence of hemorrhagic symptoms caused by vascular degeneration associated with anomalous systemic arterial (ASA) supply to the normal basal segment. We present the case of a 59-year-old man with left ASA supply to the normal basal segment who underwent video-assisted thoracoscopic surgery (VATS). The patient was admitted to our hospital with complaints of bloody sputum. Contrast-enhanced computed tomography demonstrated an anomalous artery originating from the descending aorta and supplying the basal segment of the left lower lobe. Furthermore, ground-glass opacity was observed in the relevant lung field. There were no morphological abnormalities in the bronchus of the patient. We diagnosed the patient with left ASA supply to the normal basal segment, and performed VATS dissection of the anomalous artery and left basal segmentectomy. After surgery, there were no serious complications. Pathological findings showed irreversible vascular degeneration and pulmonary alveolar hemorrhage. This case reveals interesting pathological findings associated with ASA supply to the normal basal segment. On selecting treatment for ASA supply to the normal basal segment, it is important to consider the problem of tissue degeneration.