偶発的に診断された肺葉内肺分画症に対する胸腔鏡下右肺底区域切除術の1例

Incidentally Found Intralobar Pulmonary Sequestration Undergoing Video-assisted Thoracoscopic Right Basal Segmentectomy：Report of a Case

はじめに　肺葉内肺分画症は感染を契機に診断されることが多いが，無症状で偶発的に発見されることもある．われわれは，心臓ドックを契機に分画症を指摘され，胸腔鏡下で切除した症例を経験したので，若干の文献的考察を加えて報告する．

A 53-year-old asymptomatic woman was admitted to our hospital for evaluation of an area of abnormal intensity in the right lower lobe on cardiovascular magnetic resonance imaging. She denied a history of pneumonia but occasionally expectorated bloody sputum. Contrast-enhanced chest computed tomography （CT） revealed areas of consolidations with multiple cysts within the right lower lobe and an anomalous artery that originated from the descending aorta and entered the right lower lobe. Based on contrast-enhanced CT findings, she was diagnosed with intralobar pulmonary sequestration, and we performed video-assisted thoracoscopic right basal segmentectomy. The anomalous artery was identified in the pulmonary ligament and was ligated using a silk suture at its proximal end, after which the peripheral segment was separated using an automatic suture device. The patient had an uneventful postoperative course, and plain CT at the 6-month postoperative follow-up indicated no evidence of edema of the anomalous artery stump. We recommend early surgical resection even in asymptomatic patients with pulmonary sequestration.