舌区支の転位区域気管支領域に発生した肺癌の切除

Lung Cancer in the Left Lingular Segment with a Displaced Anomalous Segmental Bronchus

気管支の分岐異常は0.6％前後であり，その中で舌区の転位気管支は非常にまれである1，2）．分岐異常領域の気管支には気管支拡張症や気管支合併症のみならず，肺癌の発生頻度が高いとの報告がある3）．分岐異常領域の気管支に肺癌が発生した場合の外科治療の問題点としては，肺血管の走行異常，リンパ節郭清の範囲，術後合併症などがあげられる．われわれは，舌区支の転位区域気管支領域に発生した肺癌の外科切除例を経験したので報告する．

The rate of bronchial anomaly is reported to be about 0.6％．Most of cases showed a displaced bronchus, mostly in the right upper lobe. We experienced lung cancer in a displaced anomalous lingular bronchus. A 76-year-old male was referred to our hospital due to abnormal mass on a chest radiograph. Thoracic computed tomography （CT） revealed a tumor with a maximum diameter of 42 mm in the left lingular segment. Bronchoscopic examination indicated a displaced anomalous right upper bronchus branching from the trachea and left B4+5 branching from the stem of the left lower lobe bronchus. Curetting was performed through the left B4+5， and adenocarcinoma was diagnosed. Lobulation between the upper and lingular segments was noted during surgery, and left lingular segmentectomy was performed. The tumor was histologically diagnosed as adenocarcinoma. The postoperative course was uneventful.