左B1＋2転位気管支と左上大静脈を伴う原発性肺癌に対し左S3＋4＋5区域切除術を施行した1例

Left S3＋4＋5 Segmentectomy with Left B1＋2 Displaced Anomalous Bronchus and Persistent Left Superior Vena Cava：Report of a Case

はじめに　副葉間裂を認める場合，気管支や血管の走行が通常と異なる場合があり注意を要する1）．われわれは左B1＋2転位気管支と左上大静脈遺残（persistent left superior vena cava：PLSVC）を伴う原発性肺癌に対し左S3＋4＋5区域切除を施行しえたので，文献的考察を加え報告する．

Chest computed tomography （CT） of a 70-year-old man revealed an accessory fissure and abnormal shadow in the left S3, which was suspected to be lung cancer. Detailed review of the CT images revealed a left B1＋2 displaced anomalous bronchus and persistent left superior vena cava. Intraoperative rapid pathological examination led to a diagnosis of adenocarcinoma；subsequently, a left S3＋4＋5 segmentectomy was performed. Surgery was performed safely because a left B1＋2 displaced anomalous bronchus and persistent left superior vena cava were confirmed preoperatively. It should be noted that bronchial and vascular anomalies may be observed in the presence of accessory fissures.