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CASE REPORT   

Minerva Pneumologica 2017 September;56(3):223-7

DOI: 10.23736/S0026-4954.17.01785-0

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

An elderly case of anomalous systemic arterial supply to the normal basal segment of the left lung

Junzo SHIMIZU 1 , Saki HAYASHI 1, Makio MORIYA 1, Tadashi KAMESUI 1, Toshiro NAGAYOSHI 2, Akitaka NONOMURA 3

1 Department of Surgery, Hokuriku Central Hospital, Oyabe, Japan; 2 Department of Radiology, Hokuriku Central Hospital, Oyabe, Japan; 3 Department of Pathology, Hokuriku Central Hospital, Oyabe, Japan


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We present the case of a 76-year-old healthy man who underwent chest radiography during a periodic medical examination, and a shadow of a mass was found in the left lower lung field, overlapping with a heart shadow. Left lung cancer was suspected. He was unaware of any symptoms such as a cough and sputum, and no abnormal breath or heart sounds were noted on auscultation. Chest computed tomography (CT) showed a shadow of an irregular-shaped mass in the hilum of the left lower lobe, suggestive of a calcified aberrant artery arising from the descending aorta and supplying the basal segments of the left lung. Contrast-enhanced chest CT showed a dilated and tortuous aberrant vessel branching off the descending aorta and perfusing the basal segments of the left lung. The calcified aberrant artery was 10 mm in diameter at its origin and was dilated to 15 mm (at the maximum) in the distal region. The left lower lobe appeared to be normal with no findings of pulmonary sequestration. The drainage vessel from the basal segments was the left inferior pulmonary vein. Three-dimensional CT did not sufficiently display the basal portion beyond branch A6 of the left pulmonary artery, suggesting atrophy or defect of the basal segmental arteries. The patient was diagnosed with anomalous systemic arterial supply to normal basal segments of the left lung-an indication for surgery because a left-to-left shunt may lead to cardiac failure and progress to the onset of pulmonary hypertension or hemoptysis.


KEY WORDS: Blood supply - Lung - Aberrant subclavian artery - Aged

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