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. 2017:38:26-28.
doi: 10.1016/j.ijscr.2017.05.035. Epub 2017 Jul 6.

A rare anomaly of the right superior pulmonary vein: Report of a case

Yoshinobu Ichiki  1 , Kesei Kakizoe  2 , Takayuki Hamatsu  2 , Taketoshi Suehiro  3 , Makiko Koike  4 , Fumihiro Tanaka  5 , Keizo Sugimachi  2
Affiliations

A rare anomaly of the right superior pulmonary vein: Report of a case

Yoshinobu Ichiki et al. Int J Surg Case Rep. 2017.

Abstract

Introduction: Although there are a lot of variations of pulmonary veins (PVs) including dangerous type that could cause serous complications during the surgery, limited information has been reported about these variations. We have experienced an extremely rare anomaly of the right superior PV.

Presentation of case: A 74-year-old man patient with right lung cancer visited our hospital. Chest computed tomography (CT) revealed a pulmonary nodule in the right lower lobe. Contrast-enhanced three-dimensional CT (3D-CT) showed that the right superior PV ran abnormally between the right main pulmonary artery (PA) and the right main bronchus. We performed right lower lobectomy and systematic nodal dissection. The operative findings confirmed that the right superior PV ran abnormally same as 3D-CT.

Discussion: In most reported cases, anomalous PVs pass behind the right bronchi or into the roof of the left atrium. The anomaly reported in the present case has been reported in only one case report. This case suggests that the space between the right main PA and the right main bronchus is not always safe for dissection.

Conclusion: Preoperative 3D-CT is useful for avoiding unexpected bleeding.

Keywords: Anomalous pulmonary vein; Lung cancer; Surgery; VATS.

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Figures

Fig. 1
Fig. 1
Chest computed tomography (CT) revealed a pulmonary nodule of 2.7 cm in diameter in the right lower lobe.
Fig. 2
Fig. 2
Contrast-enhanced three-dimensional CT (3D-CT) showed that the superior right PV abnormally ran between the right main pulmonary artery (PA) and the right main bronchus, and the right upper bronchi (B1+3 and B2) branched separately from the right main bronchus.
Fig. 3
Fig. 3
The operative findings also showed that the superior right PV abnormally ran between the right main PA and the right main bronchus.
Fig. 4
Fig. 4
The pathological findings showed papillary adenocarcinoma with areas of a lepidic, acinar or micropapillary growth involving the bronchial wall and a hilar lymph node with pleural invasion and lymphatic and vascular permeation.
See this image and copyright information in PMC

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