[A case of systemic arterial supply to the normal left basal segments with anomalous return of the left inferior pulmonary vein]

Abstract

A 38-year-old man was admitted to Yatsushiro General Hospital because of an abnormal shadow on chest X-ray film. Chest X-ray film showed a tumorous shadow in the left posterior basal segment (S10). Chest CT scan showed that this shadow was consisted of torutuous vessels and was connected to the descending thoracic aorta. Angiographic examinations showed that there was no normal left basal trunk of the pulmonary artery, and revealed an anomalous arterial supply to the basal segments from the descending thoracic aorta, with an anomalous left inferior pulmonary vein. The left bronchial tree appeared normal during fibroptic bronchoscopy (confirmed by post-operative bronchography). From these findings, we determined that this patient had an systemic arterial supply to the normal basal segments. Furthermore, this patient had an anomalous left inferior pulmonary vein, which took a peculiar route to the left atrium. The left lower lobe and the anomalous systemic artery were resected. In the resected specimen, the bronchi of the left lower lobe had a normal structure and showed a normal pattern of distribution. This anomalous systemic artery had an elastic component.