術前3D-CTでV2走行異常を確認し鏡視下区域切除を安全に施行しえた右肺癌手術例

Anomalous V2 Preoperatively Identified by Three-dimensional Computed Tomography in a Patient with Primary Lung Cancer of Right Upper Lobe

肺動静脈の走行異常は比較的高頻度でみられ，その走行様式もさまざまなものが存在するが1），肺切除における低侵襲手術や縮小手術を行う機会が増加している今日においては，術前に肺血管の走行を正確に把握することがますます重要となっている．

A 61-year-old woman was found to have multiple ground-glass nodules （GGNs） in both lungs by chest computed tomography （CT） scan. The lesion of the right S2 contained a partial solid component and was suspected to be minimally invasive adenocarcinoma. Three-dimensional CT showed two anomalous V2s descending dorsally to the intermediate bronchus and draining into the inferior pulmonary vein. Thoracoscopic segmentectomy of the right S2 was performed safely. The pathological diagnosis was adenocarcinoma in situ. Since aberrant pulmonary vessels increases the surgical risk during video-assisted thoracoscopic anatomical lung resection, preoperative three-dimensional CT is useful in performing safe surgical procedure.