同一肺葉に部分肺静脈還流異常を合併した肺癌の1切除例
部分肺静脈還流異常症（Partial Anomalous Pulmonary Venous Connection：PAPVC）は一部の肺静脈系が左心系に流入せず，右心房・上大静脈・下大静脈・奇静脈・左腕頭静脈などの右心系に流入する稀な先天奇形である．PAPVCに肺癌を合併すると切除肺葉と異常流入血管との位置関係が治療方針に重要となる事がある．症例は50歳男性，検診で胸部異常影を指摘され，精査の結果左肺腺癌と診断された．その際の術前胸部CTでPAPVCを指摘されたが，切除肺葉からの異常血管であった．肺癌に合併するPAPVCでは切除肺葉から還流する場合は特別な処置を必要としないが他肺葉に合併する場...
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| Published in | 日本呼吸器外科学会雑誌 Vol. 38; no. 4; pp. 333 - 337 |
|---|---|
| Main Authors | , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本呼吸器外科学会
15.05.2024
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0919-0945 1881-4158 |
| DOI | 10.2995/jacsurg.38.333 |
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| Abstract | 部分肺静脈還流異常症（Partial Anomalous Pulmonary Venous Connection：PAPVC）は一部の肺静脈系が左心系に流入せず，右心房・上大静脈・下大静脈・奇静脈・左腕頭静脈などの右心系に流入する稀な先天奇形である．PAPVCに肺癌を合併すると切除肺葉と異常流入血管との位置関係が治療方針に重要となる事がある．症例は50歳男性，検診で胸部異常影を指摘され，精査の結果左肺腺癌と診断された．その際の術前胸部CTでPAPVCを指摘されたが，切除肺葉からの異常血管であった．肺癌に合併するPAPVCでは切除肺葉から還流する場合は特別な処置を必要としないが他肺葉に合併する場合には右心不全の懸念が生じ，慎重な手術戦略の検討を要する．今回我々は術前に診断し得たPAPVCに合併した肺癌を，術後合併症なく安全に肺葉切除を施行できた一例を経験したので文献的考察を加えて報告する． |
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| AbstractList | 部分肺静脈還流異常症（Partial Anomalous Pulmonary Venous Connection：PAPVC）は一部の肺静脈系が左心系に流入せず，右心房・上大静脈・下大静脈・奇静脈・左腕頭静脈などの右心系に流入する稀な先天奇形である．PAPVCに肺癌を合併すると切除肺葉と異常流入血管との位置関係が治療方針に重要となる事がある．症例は50歳男性，検診で胸部異常影を指摘され，精査の結果左肺腺癌と診断された．その際の術前胸部CTでPAPVCを指摘されたが，切除肺葉からの異常血管であった．肺癌に合併するPAPVCでは切除肺葉から還流する場合は特別な処置を必要としないが他肺葉に合併する場合には右心不全の懸念が生じ，慎重な手術戦略の検討を要する．今回我々は術前に診断し得たPAPVCに合併した肺癌を，術後合併症なく安全に肺葉切除を施行できた一例を経験したので文献的考察を加えて報告する． |
| Author | 竹内, 真吾 吉野, 直之 臼田, 実男 |
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| References | 17. Kawagoe I, Hayashida M, Nozumi S, Banno T, Hirayama S, Suzuki K, et al. A combination of a partial anomalous pulmonary venous connection (PAPVC) and a lung tumor requiring pulmonary resection. J Cardiothorac Vasc Anesth 2017; 31: 274-8. 2. Takamori S, Hayashi A, Nagamatsu Y, Tayama K, Kakegawa T. Left partial anomalous pulmonary venous connection found during a lobectomy for lung cancer: Report of a case. Surg Today 1995; 25: 982-3. 5. Miwa K, Takamori S, Hayashi A, Fukunaga M, Ikeda K, Shirouzu K. Incidental partial anomalous pulmonary venous connection in left lung cancer. Jpn J Thorac Cardiovasc Surg 2004; 52: 189-90. 16. Tamburini N, Marchi I, Bassi M, Anania G, Quarantotto F, Cavallesco G, et al. Misdiagnosis of anomalous pulmonary venous connections in a patient with lung cancer and a review of the literature. J Thorac Dis 2017; 9: E723-6. 18. 平野 豊, 鷲尾一浩. 部分肺静脈還流異常を伴った両側肺癌の切除例. 日呼外会誌 2018; 32: 686-90. 21. Kurihara N, Saito H, Usami S, Imai K, Konno H, Atari M, et al. Lung cancer surgery in partial anomalous pulmonary venous connection patients. Ann Thorac Surg 2018; 105: E7-9. 22. Watanabe H, Kanauchi N, Abe K, Matsuno S. Lung cancer with partial anomalous pulmonary venous connection in a different lobe: a case report. J Cardiothorac Surg 2021; 16: 122. 7. Sasaki H, Naka N, Kitahara N, Yoshikawa S, Goto M, Tamura M, et al. Right partial anomalous pulmonary venous connection found during lobectomy for coexisting lung cancer and tuberculosis: report of a case. Clin Lung Cancer 2006; 7: 350-2. 13. 福原光朗, 木下裕康, 飯島慶仁, 中島由貴, 鈴木弘行, 浦本秀隆. 術前に指摘し得た部分肺静脈還流異常合併肺癌の1切除例. 日呼外会誌 2016; 30: 514-8. 23. Ohtaka K, Hida Y, Kaga K, Kato T, Muto J, Nakada-Kubota R, et al. Thrombosis in the pulmonary vein stump after left upper lobectomy as possible cause of cerebral infarction. Ann Thoracic Surg 2013; 95: 1924-8. 11. Asakura K, Izumi Y, Kohno M, Watanabe M, Arai T, Nomori H. Partial anomalous pulmonary venous connection associated with lung cancer in the same lobe: report of a case. Ann Thorac Cardiovasc Surg 2014; 20: 457-60. 4. 秋山博彦, 岡田大輔, 榎本 豊, 西村仁志. 肺癌手術時に発見された部分肺静脈還流異常の1例. 肺癌 2003; 43: 711-4. 8. Tanaka R, Nakazato Y, Fukura H, Horikoshi H, Sawada T, Goya T. Partial anomalous pulmonary venous connection in right lung cancer: report of a case. Surg Today 2008; 38: 147-9. 3. Takei H, Suzuki K, Asamura H, Kondo H, Tsuchiya R. Successful pulmonary resection of lung cancer in a patient with partial anomalous pulmonary venous connection: Report of a case. Surg Today 2002; 32: 899-901. 6. Sakurai H, Kondo H, Sekiguchi A, Naruse Y, Makuuchi H, Suzuki K, et al. Left pneumonectomy for lung cancer after correction of contralateral partial anomalous pulmonary venous return. Ann Thorac Surg 2005; 79: 1778-80. 20. 米井彰洋, 吹井聖継, 森山裕一. 同一肺葉に部分肺静脈還流異常を合併した肺腺癌の1手術例. 日呼外会誌 2019; 33: 442-7. 1. Black MD, Shamji FM, Goldstein W, Sachs HJ. Pulmonary resection and contralateral anomalous venous drainage: A lethal combination. Ann Thorac Surg 1992; 53: 689-91. 10. 村西佑介, 上島康生, 村西菜苗, 塩津伸介, 内匠千恵子, 平岡範也. 術前に部分肺静脈還流異常の合併を指摘しえた肺癌の1例. 日呼吸会誌 2013; 2: 385-8. 9. Mikubo M, Ikeda S, Hoshino T, Yokota T, Fujii A, Mori M. Pulmonary resection of lung cancer in a patient with partial anomalous pulmonary venous connection. Ann Thorac Surg 2013; 95: 1799-801. 14. Inafuku K, Morohoshi T, Adachi H, Koumori K, Masuda M. Thoracoscopic lobectomy for lung cancer in a patient with a partial anomalous pulmonary venous connection: a case report. J Cardiothorac Surg 2016; 11: 113. 12. Tourmousoglou C, Kalogeropoulou C, Koletsis E, Charoulis N, Prokakis C, Alexopoulos P, et al. Right upper lobe partial anomalous pulmonary venous connection. Case Rep Vasc Med 2014; 2014: 249896. 15. Kawasaki H, Oshiro Y, Taira N, Furugen T, Ichi T, Yohena T, et al. Partial anomalous pulmonary venous connection coexisting with lung cancer: a case report and review of relevant cases from the literature. Ann Thorac Cardiovasc Surg 2017; 23: 31-5. 19. Akabane M, Kohno T, Fujimori S, Kimura N, Suzuki S, Kawashima M, et al. Simultaneous three-port thoracoscopic surgery for bilateral lung cancers with a pulmonary vein anomaly: a case report. Int J Surg Case Rep 2019; 54: 66-9. |
| References_xml | – reference: 5. Miwa K, Takamori S, Hayashi A, Fukunaga M, Ikeda K, Shirouzu K. Incidental partial anomalous pulmonary venous connection in left lung cancer. Jpn J Thorac Cardiovasc Surg 2004; 52: 189-90. – reference: 20. 米井彰洋, 吹井聖継, 森山裕一. 同一肺葉に部分肺静脈還流異常を合併した肺腺癌の1手術例. 日呼外会誌 2019; 33: 442-7. – reference: 9. Mikubo M, Ikeda S, Hoshino T, Yokota T, Fujii A, Mori M. Pulmonary resection of lung cancer in a patient with partial anomalous pulmonary venous connection. Ann Thorac Surg 2013; 95: 1799-801. – reference: 2. Takamori S, Hayashi A, Nagamatsu Y, Tayama K, Kakegawa T. Left partial anomalous pulmonary venous connection found during a lobectomy for lung cancer: Report of a case. Surg Today 1995; 25: 982-3. – reference: 7. Sasaki H, Naka N, Kitahara N, Yoshikawa S, Goto M, Tamura M, et al. Right partial anomalous pulmonary venous connection found during lobectomy for coexisting lung cancer and tuberculosis: report of a case. Clin Lung Cancer 2006; 7: 350-2. – reference: 1. Black MD, Shamji FM, Goldstein W, Sachs HJ. Pulmonary resection and contralateral anomalous venous drainage: A lethal combination. Ann Thorac Surg 1992; 53: 689-91. – reference: 8. Tanaka R, Nakazato Y, Fukura H, Horikoshi H, Sawada T, Goya T. Partial anomalous pulmonary venous connection in right lung cancer: report of a case. Surg Today 2008; 38: 147-9. – reference: 17. Kawagoe I, Hayashida M, Nozumi S, Banno T, Hirayama S, Suzuki K, et al. A combination of a partial anomalous pulmonary venous connection (PAPVC) and a lung tumor requiring pulmonary resection. J Cardiothorac Vasc Anesth 2017; 31: 274-8. – reference: 4. 秋山博彦, 岡田大輔, 榎本 豊, 西村仁志. 肺癌手術時に発見された部分肺静脈還流異常の1例. 肺癌 2003; 43: 711-4. – reference: 15. Kawasaki H, Oshiro Y, Taira N, Furugen T, Ichi T, Yohena T, et al. Partial anomalous pulmonary venous connection coexisting with lung cancer: a case report and review of relevant cases from the literature. Ann Thorac Cardiovasc Surg 2017; 23: 31-5. – reference: 18. 平野 豊, 鷲尾一浩. 部分肺静脈還流異常を伴った両側肺癌の切除例. 日呼外会誌 2018; 32: 686-90. – reference: 11. Asakura K, Izumi Y, Kohno M, Watanabe M, Arai T, Nomori H. Partial anomalous pulmonary venous connection associated with lung cancer in the same lobe: report of a case. Ann Thorac Cardiovasc Surg 2014; 20: 457-60. – reference: 14. Inafuku K, Morohoshi T, Adachi H, Koumori K, Masuda M. Thoracoscopic lobectomy for lung cancer in a patient with a partial anomalous pulmonary venous connection: a case report. J Cardiothorac Surg 2016; 11: 113. – reference: 23. Ohtaka K, Hida Y, Kaga K, Kato T, Muto J, Nakada-Kubota R, et al. Thrombosis in the pulmonary vein stump after left upper lobectomy as possible cause of cerebral infarction. Ann Thoracic Surg 2013; 95: 1924-8. – reference: 13. 福原光朗, 木下裕康, 飯島慶仁, 中島由貴, 鈴木弘行, 浦本秀隆. 術前に指摘し得た部分肺静脈還流異常合併肺癌の1切除例. 日呼外会誌 2016; 30: 514-8. – reference: 16. Tamburini N, Marchi I, Bassi M, Anania G, Quarantotto F, Cavallesco G, et al. Misdiagnosis of anomalous pulmonary venous connections in a patient with lung cancer and a review of the literature. J Thorac Dis 2017; 9: E723-6. – reference: 3. Takei H, Suzuki K, Asamura H, Kondo H, Tsuchiya R. Successful pulmonary resection of lung cancer in a patient with partial anomalous pulmonary venous connection: Report of a case. Surg Today 2002; 32: 899-901. – reference: 12. Tourmousoglou C, Kalogeropoulou C, Koletsis E, Charoulis N, Prokakis C, Alexopoulos P, et al. Right upper lobe partial anomalous pulmonary venous connection. Case Rep Vasc Med 2014; 2014: 249896. – reference: 22. Watanabe H, Kanauchi N, Abe K, Matsuno S. Lung cancer with partial anomalous pulmonary venous connection in a different lobe: a case report. J Cardiothorac Surg 2021; 16: 122. – reference: 21. Kurihara N, Saito H, Usami S, Imai K, Konno H, Atari M, et al. Lung cancer surgery in partial anomalous pulmonary venous connection patients. Ann Thorac Surg 2018; 105: E7-9. – reference: 6. Sakurai H, Kondo H, Sekiguchi A, Naruse Y, Makuuchi H, Suzuki K, et al. Left pneumonectomy for lung cancer after correction of contralateral partial anomalous pulmonary venous return. Ann Thorac Surg 2005; 79: 1778-80. – reference: 10. 村西佑介, 上島康生, 村西菜苗, 塩津伸介, 内匠千恵子, 平岡範也. 術前に部分肺静脈還流異常の合併を指摘しえた肺癌の1例. 日呼吸会誌 2013; 2: 385-8. – reference: 19. Akabane M, Kohno T, Fujimori S, Kimura N, Suzuki S, Kawashima M, et al. Simultaneous three-port thoracoscopic surgery for bilateral lung cancers with a pulmonary vein anomaly: a case report. Int J Surg Case Rep 2019; 54: 66-9. |
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| Snippet | 部分肺静脈還流異常症（Partial Anomalous Pulmonary Venous Connection：PAPVC）は一部の肺静脈系が左心系に流入せず，右心房・上大静脈・下大静脈・奇静脈・左腕頭静... |
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| SubjectTerms | 肺癌 肺葉切除術 部分肺静脈還流異常症 |
| Title | 同一肺葉に部分肺静脈還流異常を合併した肺癌の1切除例 |
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