左上肺静脈部分還流異常を伴う胸腺腫の1例

Thymoma with Partial Anomalous Pulmonary Venous Drainage from the Left Upper Lobe：Report of a Case

はじめに　成人の呼吸器外科手術で遭遇しうる血管走行異常の一つに肺静脈部分還流異常がある．肺静脈部分還流異常が切除する肺葉に存在すれば問題にならないが，ほかの肺葉に存在する場合は左右シャント量の増大により右心不全を起こす可能性がある1）．われわれは，左上肺静脈部分還流異常を伴う胸腺腫の1切除例を経験したので報告する．

A 73-year-old woman presented with left anterior chest pain and back pain. Computed tomography （CT） scan showed an anterior mediastinal tumor. It also showed partial anomalous pulmonary venous drainage （left superior pulmonary vein draining into the left brachiocephalic vein）, and the tumor was located near the left brachiocephalic vein. The operation was performed through a median sternotomy to resect the thymus and tumor with partial resection of the left upper lobe due to the tumor’s adhesion to the left upper lobe. One of the vascular anomalies encountered in adult thoracic surgery is partial anomalous pulmonary venous drainage. It is important to recognize the presence of such an anomaly on imaging and to anticipate the surgical procedure with a preoperative surgical technique.