A pulmonary nodule mislocated in “dorsal” segment due to tri-lobed left lung

Frontiers in Surgery

Surgery

Yuan Xu¹  Yingzhi Qin¹  Hongsheng Liu¹  Dongjie Ma¹  Xiaohong Lyu² 

[1] Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China;Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China;Beijing, China;

关键词: lung cancer surgery;    diagnosis;    lung cancer;    CT scan;    computed tomography;    chest;    anatomy;   

DOI  :  10.3389/fsurg.2022.1069543

 received in 2022-10-14, accepted in 2022-10-25,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundThe left lung has two lobes and one fissure, while the right lung has three lobes and two fissures. Accessory fissures are usually found in imaging examinations and autopsies; however, finding an actual accessory lobe is rare.Case presentationIn a lung nodule resection surgery, a 68-year-old male patient was found with three lobes and two fissures in his left lung. The lung nodule was misdiagnosed as being located in the lower lobe because the accessory fissure was misregarded as the oblique fissure. The lung nodule was found in the upper lobe, and this anatomical variation changed the surgical plan. The pathology of the lung nodule was granulomatous inflammation with caseous necrosis with the positive antacid stain. The patient was eventually diagnosed with tuberculosis.Literature reviewCases involving the lung accessory fissure and lung accessory lobe variants were reviewed. In 10 autopsy and dissection studies, the incidence of accessory fissure in the left lung was 13.5% (79/587, ranging from 2.7% to 50.0%), and in the right lung, it was 7.3% (42/575, ranging from 3.1% to 30.4%). The incidence of accessory lobes in the left lung was 2.0% (11/547, ranging from 0.0% to 7.4%), and in the right lung was 2.6% (14/539, ranging from 0.0% to 17.4%). The incidence of accessory fissures in bilateral lungs identified by chest x-ray or computed tomography ranged from 7.3% to 32.0%. Three surgical case reports inferred accessory lobes, including a left upper lobectomy, left lung transplantation, and an open thoracotomy.ConclusionThis is the first clinical case report that shows that lung accessory lobe caused the mislocation of a lung nodule. Therefore, radiologists and surgeons should be aware of the possibility of an accessory lobe in the lung.

【 授权许可】

Unknown   
© 2023 Lyu, Xu, Qin, Ma and Liu.