The Journal of the Japan Society for Respiratory Endoscopy
Online ISSN : 2186-0149
Print ISSN : 0287-2137
ISSN-L : 0287-2137
Case Reports
Right Upper Lung Cancer Accompanied by Missing B2, B3 and a Displaced Anomalous B6 Bronchus
Takehiro TsuchiyaShin KaritaMakoto Tanaka
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JOURNAL FREE ACCESS

2019 Volume 41 Issue 1 Pages 85-89

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Abstract

Background. Bronchial anomalies are rare. We report a case of right upper lung cancer with missing B2, B3 and a displaced anomalous B6 bronchus. Case. A 76-year-old woman was admitted to our hospital for detailed examination after the detection of a chest X-ray abnormality. Chest CT and bronchoscopy showed a tumor in the right upper lobe. In addition, the A2, A3, V2, and V3 of the right lung were missing, and B6 branched from the intermediate bronchus. Since the pathologic diagnosis was lung adenocarcinoma, we performed right upper lobectomy. Bronchial anomalies are thought to be associated with anomalous blood vessels. In our case, preoperative 3D-CT showed that V1 and a small pulmonary vein flowed into the upper pulmonary vein. While the small vein was thought to flow from the right upper lobe, intraoperative observation showed that it was actually a pulmonary vein arising from S6. Conclusion. 3D-CT is often useful when planning operative procedures. However, it is difficult to identify the inlet and outlet portions of the blood vessel when the blood vessel shows positional abnormality. Thus, intraoperative observation is also important for achieving safe surgical outcomes.

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© 2019 The Japan Society for Respiratory Endoscopy
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