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第45巻第4号目次 | Japanese/English |
 | Full Text of PDF (165K) Article in Japanese |
─ 症例 ─
Squamous Cell Lung Cancer Associated With an Anomaly of the Right Upper Lobe Bronchus
Osamu Hashimoto1, Akira Yamaguchi1, Tami Fujimoto2Department of 1Thoracic Surgery, 2Internal Medicine, Chiba Tokushukai Hospital, Japan
Background. Anomalous right upper and middle lobe bronchi originating from a common bronchus is a rare condition. We report a case of lung cancer associated with this anomaly. Case. A 67-year-old woman complained of productive cough and chest pain. A diagnosis of pneumonia was made in the right lung. Despite antibiotics, the shadow in the right lower lung field did not disappear. Therefore she underwent computed tomographic (CT) scan which revealed a mass in the right middle lobe. She was referred to our hospital on the suspicion of lung cancer. Bronchoscopy revealed right upper and middle lobe bronchi originating from a common bronchus. Squamous cell carcinoma was confirmed by curetting cytology of the right middle lobe bronchus. Bilobectomy of the right upper and middle lobes and lymphadenectomy was performed through a thoracotomy. After giving rise anteriorly to a large stem, the truncus superior (TS), the remaining stem of the right pulmonary artery, descended dorsally under the arch of the azygos vein. As the TS was thick, these two stems together presented a double-barreled appearance at surgery. The configuration of the dorsal stem after the branching off of the TS was similar to that seen in the left lung. No minor fissure between the upper and middle lobes was observed, and the posterior part of the major fissure was undeveloped. There was no abnormality in the pulmonary veins. The postoperative course of the patient was uneventful, and she was discharged on the fifth postoperative day. The pathologic diagnosis was stage IA squamous cell carcinoma. Conclusion. The bronchial anomaly was a mirror image of the left upper lobe bronchus. We were able to image the anatomic ramifications of the right pulmonary arteries by CT and 3D-CT scans. Pulmonary arteriography would have been optimal before surgery.
索引用語：Congenital bronchial anomaly, Mirror image of the left lung, Squamous cell lung cancer
受付日：2004年4月16日
受理日：2005年5月12日
肺癌 45 (4)：367─372，2005
