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- Case Report -

A Resected Case of Lung Cancer with a Displaced Anomalous Bronchus of the Left Upper Lobe

Emiko Tomita¹, Kenjiro Fukuhara¹, Naoto Takase², Yoshitane Tsukamoto³, Akinori Akashi^1
1Department of General Thoracic Surgery, ²Department of Respiratory Medicine, ³Department of Pathology, Takarazuka City Hospital, Japan

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Background. The frequency of anomalous bronchus has been increasing in recent years with the improvement of bronchoscopy and computed tomography (CT) modalities; however, a displaced anomalous bronchus is a rare disorder of the left upper lobe. We herein report a case of surgery for lung cancer with a displaced anomalous bronchus of the left upper lobe. Case. Chest CT showed a 19-mm nodule in the left S¹⁺² when a 76-year-old man underwent catheterization surgery for a heart attack at the previous hospital. Bronchoscopy did not reveal any malignancy. He was referred to our hospital due to a strong suspicion that the nodule was primary lung cancer (cT1bN0M0 Stage IA2). Three-dimensional chest CT for the preoperative examination revealed a displaced anomalous left B¹⁺² arising from the left main bronchus and a lack of the left B⁶. VATS S¹⁺²a+b segmentectomy was performed, and a final diagnosis of poorly differentiated squamous cell carcinoma (pT2aN0M0 Stage IB) was made. No recurrence had occurred by 3.5 years after surgery. Conclusion. The standard surgery for lung cancer with a displaced anomalous bronchus has not yet been established. However, the present case suggests that segmentectomy of the relevant section of a displaced anomalous bronchus is a reasonable approach, and ND2a-1 is preferable for lung cancer with a displaced anomalous bronchus of the left upper lobe, although the anatomical position and surgical margin to the side of the fused fissure must be considered.
key words: Bronchial anomaly, Displaced anomalous bronchus, Lung cancer, Surgery

Received: October 10, 2019
Accepted: November 30, 2019

JJLC 60 (1): 60-65, 2020