Aspergillus感染と動脈瘤化した異常動脈を伴った肺葉内肺分画症の1例

Intralobar Sequestration Associated with Aneurysm of the Aberrant Artery and Aspergillus Infection：Report of a Case

はじめに　肺葉内と肺葉外に分類される肺分画症の中でも，肺葉内肺分画症は分画肺への感染により繰り返す肺炎などを契機に発見されることが多いが，Aspergillusの感染報告は少ない．われわれは，Aspergillus感染に加えて，さらにまれとされる動脈瘤化した異常動脈を有した肺葉内肺分画症の1切除例を経験したので報告する．

A 32-year-old man was referred to our department for surgery because of recurrent pneumonia. Aspergillus fumigatus was detected in his sputum culture at the first visit. We started antifungal therapy one month before surgery. His chest radiograph showed an infiltrative shadow in the right lower lobe, and chest computed tomography （CT） showed an infiltrative shadow and large and small cystic changes in the right lower lobe. CT angiography （CTA） revealed two anomalous arteries supplied by the aorta that drained into the right lower lobe. An aneurysm with a diameter of 25 mm had formed in one anomalous artery. Based on these findings, intralobar pulmonary sequestration with Aspergillus infection and an anomalous artery forming an aneurysm was diagnosed. In addition, we embolized the aneurysm of the anomalous artery. After embolization, right lower lobectomy was safely performed. The patient was discharged on the 15th post-operative day with no complications.