Anomalous V 2 of the left pulmonary vein detected using three-dimensional computed tomography in a patient with lung cancer: A case report

Aragaki, Masato; Iimura, Yasuaki; Yoshida, Yusuke; Hasegawa, Naoto

doi:10.1016/j.ijscr.2017.06.046

Cited by 12 publications

(13 citation statements)

References 7 publications

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“…In the report about variations of the course of the PV by Shiina et al, the prevalence on the left side was 2.6%, which was less frequent than on the right side at 32.8% [16]. Among variations of the course of left V 1+2 , the variation that passed to the dorsal side of the pulmonary hilum and joined V 6 or the inferior PV was more frequent than the others [17, 18]. In the present case, the left V 1+2 passed between B 6 and the bronchus to the basal segment and joined V 6 at the dorsal side of the pulmonary hilum.…”

Section: Discussionmentioning

confidence: 99%

A left lung abscess with a displaced subsegmental bronchus and anomalous pulmonary artery and vein: a case report

et al. 2019

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Background Since a displaced bronchus related to the left upper lobe is an uncommon anatomical anomaly, it has a risk of being accidentally resected during left upper lobe resection unless they are identified preoperatively. A case of video-assisted thoracic surgery (VATS) segmentectomy that was safely performed under preoperative identification of a displaced subsegmental bronchus and anomalous pulmonary vessels is presented. Case presentation A 48-year-old woman visited our hospital because of an abnormal shadow on a radiograph on a health check. The chest computed tomography (CT) showed a multicystic mass with a diameter of 35 mm on dorsal interlobar parenchyma between the S 1+2 and S 6 segments in the left lung. The three-dimensional (3D) CT with multiplanar reconstruction showed that B 1+2 b+c passed to the dorsal side of the left main pulmonary artery (PA), which was considered a displaced bronchus. The branch of A 6 arose from the left main PA at the level of the branches of A 3 and A 1+2 , more proximal than the normal anatomy, and passed to the dorsal side of a displaced B 1+2 b+c. The branch of V 1+2 passed between B 6 and the bronchus to the basal segment and joined V 6 at the dorsal side of the pulmonary hilum. Intraoperative findings of the anatomy of the bronchi and pulmonary vessels were exactly the same as the preoperative 3D CT findings, so segmentectomy of S 1+2 b+c and S 6 by VATS was performed safely. Then there were accessory fissures between S 1+2 and S 3 and between S 6 and the basal segment. The pathological diagnosis was a left lung abscess. Conclusions A preoperative 3D CT may be helpful for identifying anatomical anomalies. An anatomical anomaly should be suspected if accessory fissure is found during surgery.

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Section: Discussionmentioning

confidence: 99%

A left lung abscess with a displaced subsegmental bronchus and anomalous pulmonary artery and vein: a case report

et al. 2019

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“…5 On the left side, the most prevalent variation found in humans is the common trunk of the left superior and inferior pulmonary vein but various unusual patterns have been observed as venous branches from the lingular segment (V 4 þ V 5 ) emptying into the inferior pulmonary vein; inferior lingular pulmonary vein (V 5 ) draining into the left atrium; anomalous vein for the apicoposterior segment of the left upper lobe (V 2 ) draining into the left inferior pulmonary vein; and lower lobe apical segmental vein (V 6 ) flow in the superior pulmonary vein. 2,6,7 Usually, right-sided variations are more frequent than on the left side. Some authors have reported middle lobe veins joining the inferior pulmonary vein as a single trunk or separately, independent drainage of the middle lobe veins directly into the left atrium or the lateral part of the middle lobe vein (V 4 ) and the medial part of the middle lobe vein (V 5 ) draining, respectively, into the inferior and superior pulmonary vein.…”

Section: Discussionmentioning

confidence: 99%

“…Preoperative CT scan identification of anatomical variations in the pulmonary venous system may help prevent iatrogenic complications such as uncontrolled bleeding, severe lung edema, or extension of pulmonary resections. 7 Pulmonary vascular anomalies sometimes are not detected on preoperative CT scans and for this reason we always recommend a careful dissection during major lung resections, especially in minimally invasive thoracic surgery where homeostasis following vessel injury can be more complicated. 2…”

Section: Discussionmentioning

confidence: 99%

Common and Uncommon Variations of Pulmonary Venous Drainage in Patients Undergoing Thoracoscopic Lobectomy

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et al. 2019

Thorac cardiovasc Surg

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Background Variations in pulmonary venous anatomy should not be undermined by thoracic surgeons during procedures which involve the pulmonary veins. Methods We have identified vascular anomalies in 25 of 346 patients undergoing video-assisted thoracoscopic surgery lobectomy at our Thoracic Surgery Unit, between December 2016 and November 2018. Results Some vascular anomalies described have not been reported in recent literature and include right V7 draining into the middle lobe pulmonary vein, accessory right V6 behind the bronchus intermedius, two V6 from the apical segment of left lower lobe, two V6 from the apical segment of right lower lobe, and one of them draining into the superior pulmonary vein. Conclusion Thoracic surgeons should be aware of this type of anomalies because failure in the preoperative or intraoperative identification of the pulmonary venous variations may lead to serious complications.

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“…Aragaki et al . reported preoperative recognition of the left V 2 draining into V 6 on 3D‐CT and the successful preservation of the V 5 during VATS LLL resection . Ishikawa et al .…”

Section: Discussionmentioning

confidence: 99%

Variations of pulmonary vein drainage critical for lung resection assessed by three‐dimensional computed tomography angiography

et al. 2018

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BackgroundIt is important to understand pulmonary vein drainage pattern variations and their frequency in order to perform safe anatomical pulmonary resection.MethodsVariations and frequencies were assessed using three‐dimensional computed tomography angiography (3D‐CT) in 194 patients. In cases where the tumor or lymph node caused atelectasis or compression of hilar structures, the involved lobes were excluded from the analyses.ResultsWe confirmed variant drainage patterns in 15/189 (8.0%) patients in the right upper lobe (RUL), 29/189 (15.3%) in the right middle lobe (RML), 18/192 (9.5%) in the right lower lobe (RLL), and 5/187 (2.6%) in the left upper lobe (LUL). There was no variant type in the left lower lobe (LLL). There were 14 (7.4%) cases of anomalous superior posterior pulmonary vein of RUL (V2) drainage: V2 draining to the superior pulmonary vein (SPV) (n = 2, 1.1%), V2 to the inferior pulmonary vein (IPV) (n = 7, 3.7%), V2 to the left atrium (LA) (n = 2, 1.1%), and V6 to the apical pulmonary vein of the RLL (n = 3, 1.6%). There was a posterior pulmonary vein, V3 to RML pulmonary vein in one case (0.5%). The RML pulmonary vein drained into the IPV in 14 (7.4%) and into the LA in 15 (7.9%) cases. The right V6 directly drained into the LA in 15 (7.9%) and V6 into the SPV in 3 (1.6%) cases. The lingular pulmonary vein drained into the IPV in one case (0.5%) and into the LA in two cases (1.1%). The inferior lingular pulmonary vein V5 drained into the IPV and into the LA in one case (0.5%), respectively.ConclusionWe describe anomalous pulmonary venous drainage patterns and their frequencies particular to anatomic surgical resection. 3D‐CT is useful to find such variations.

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Anomalous V 2 of the left pulmonary vein detected using three-dimensional computed tomography in a patient with lung cancer: A case report

Cited by 12 publications

References 7 publications

A left lung abscess with a displaced subsegmental bronchus and anomalous pulmonary artery and vein: a case report

A left lung abscess with a displaced subsegmental bronchus and anomalous pulmonary artery and vein: a case report

Common and Uncommon Variations of Pulmonary Venous Drainage in Patients Undergoing Thoracoscopic Lobectomy

Variations of pulmonary vein drainage critical for lung resection assessed by three‐dimensional computed tomography angiography

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