Lung adenocarcinoma with anomalous bronchi and pulmonary veins preoperatively identified by computed tomography

Abstract

A 69-year-old woman visited our hospital complaining of right chest pain. Chest computed tomography showed a 55 × 45 mm tumor in the right upper lobe. Bronchoscopy revealed displaced anomalous B 1 and B 2+3 arising from the right main bronchus, and the patient was diagnosed with lung adenocarcinoma by transbronchial lung biopsy from the displaced B 2+3. Three-dimensional computed tomography with multiplanar reconstruction revealed a displaced anomalous B 1 and B 2+3 branching directly from the right main bronchus, respectively, and abnormal distribution of the aberrant pulmonary vein (V 2) descended dorsally to the right main bronchus and emptied into the left atrium. Video-assisted right upper lobectomy with nodal dissection was successfully performed. Attention should be paid to the anomalous bronchus and pulmonary vessels for safer lung cancer operations, especially for video-assisted thoracic surgery.