奇静脈葉を伴う手掌多汗症

Palmar Hyperhidrosis Associated with the Azygos Lobe

奇静脈葉はまれな肺の形成異常であり，通常は臨床的に問題となるものではないが，胸腔鏡下手術を実施する際には注意を要する病態である．われわれは，手掌多汗症に対する胸部交感神経節切除の実施に際して術前に奇静脈葉の存在を確認し，安全に手術を遂行できた症例を経験したので報告する．

A 66-year-old man visited our department because of palmar hyperhidrosis. Computed tomography had revealed division of the right upper lobe by a fissure and the azygos vein, and the presence of an azygos lobe had been diagnosed. Endoscopic thoracic sympathectomy （resection of T3 ganglion） was performed. Adhesion between the azygos lobe and parietal pleura was dissected to pulling out the azygos lobe and the sympathectomy was safely performed.