Posterior Basal Segment Research Articles

Analysis of CT signs in 85 cases with peripheral lung cancer

Objective To analyze the CT signs of peripheral lung cancer. Methods From July 2012 to June 2017, the clinical data of 85 patients with peripheral lung cancer examined by CT in the People's Hospital of Longyou County were retrospectively analyzed.CT findings were analyzed and compared with the results of postoperative pathological diagnosis. Results CT examination showed that the lesions were located in the posterior segment of the right upper lung, the dorsal segment of the double lower lobe, the posterior segment of the left superior pulmonary apex, the anterior segment of the bilateral upper lobe and the posterior basal segment of the right lower lobe in 56 cases, accounted for 65.88%.The shape of the mass was spherical or nearly spherical in 95.29%.The diameter of the mass ≤50mm in 58 cases, accounted for 68.23%.The density of the mass was even in 72 cases, and 13 cases were inhomogeneous.The proportions of lobulation sign, burr sign, spinous process sign, pleural depression sign, bronchovascular concentration sign and vacuole sign were 94.12%, 88.24%, 89.41%, 92.94%, 52.94%, 88.24%, respectively. Conclusion CT findings and case-based analysis of patients with peripheral lung cancer are of great importance in the diagnosis of patients with peripheral lung cancer, and play a significant role in the clinical efficacy. Key words: Lung neoplasms; Tomography, X-ray computed; Diagnosis

Thoracoscopic anatomical S10 segmentectomy: a posterior approach

Although previous reports have described thoracoscopic segmentectomies, an anatomical thoracoscopic posterior basal segmentectomy is difficult to perform because arteries and bronchi are located deep within the parenchyma in the vicinity of the major fissure and the presence of multiple dissection surfaces. In addition, separation of superior and anterior basal segments occurs to perform this resection from the interlobar fissure. We developed a posterior approach for the resection of the posterior (S10) or the lateral and posterior (S9+10) basal segments based on three-dimensional computed tomography (3D-CT) surgical simulation. To date, we have performed 28 port access anatomical lung segmentectomies using this posterior approach. The primary steps of the surgical procedure have been presented in this article.

Thoracoscopic stapler-based "bidirectional" segmentectomy for posterior basal segment (S10) and its variants.

Thoracoscopic segmentectomy for the posterior basal segment (S10) and its variant (e.g., S9+10 and S10b+c combined subsegmentectomy) is one of the most challenging anatomical segmentectomies. Stapler-based segmentectomy is attractive to simplify the operation and to prevent post-operative air leakage. However, this approach makes thoracoscopic S10 segmentectomy even more tricky. The challenges are caused mostly from the following three reasons: first, similar to other basal segments, "three-dimensional" stapling is needed to fold a cuboidal segment; second, the belonging pulmonary artery is not directly facing the interlobar fissure or the hilum, making identification of target artery difficult; third, the anatomy of S10 and adjacent segments such as superior (S6) and medial basal (S7) is variable. To overcome these challenges, this article summarizes the "bidirectional approach" that allows for solid confirmation of anatomy while avoiding separation of S6 and the basal segment. To assist this approach under limited thoracoscopic view, we also show stapling techniques to fold the cuboidal segment with the aid of "standing stiches". Attention should also be paid to the anatomy of adjacent segments particularly that of S7, which tends to be congested after stapling. The use of virtual-assisted lung mapping (VAL-MAP) is also recommended to demark resection lines because it flexibly allows for complex procedures such as combined subsegmentectomy such as S10b+c, extended segmentectomy such as S10+S9b, and non-anatomically extended segmentectomy.

Using novel technology to augment complex video-assisted thoracoscopic single basilar segmentectomy.

There are many novel technologies that enable complex segmentectomy to be performed. As lung cancer screening becomes more prevalent, patients are increasingly diagnosed with early stage lung cancer, multifocal disease, and second primary tumors. This shift to an earlier clinical presentation combined with advances in technology and an emphasis on minimally invasive techniques have led to the current developments we are now seeing with anatomic segmentectomy. In this paper, we describe the operative technique of an indocyanine green (ICG)-guided video-assisted thoracoscopic surgery (VATS) single basilar segmental resection, augmented with methylene blue dye marker localization via SuperDimension electromagnetic navigational bronchoscopy. The CT scans of the posterior basal segment tumor are enhanced with three-dimensional (3D) modeling. A description of the approach is detailed with a video, intraoperative photographs, and illustrations. Successful removal of the S10 segment with novel techniques permitted the patient to have five percent of the lung removed (segmentectomy) instead of 25% (right lower lobectomy). In the setting of multifocal disease, future treatment options for the tumors in other locations of the lung are enhanced. Novel lung imaging techniques along with careful intraoperative identification of appropriate segmental anatomy allow patients to be offered an optimal basilar parenchymal-sparing segmentectomy.

Bronchopulmonary sequestration as a cause of mismatched perfusion defect on single-photon emission computed tomography ventilation-perfusion scan

We present a 46-year-old female with pleuritic chest pain on a background of pulmonary embolism diagnosed on a single-photon emission computed tomography (SPECT) ventilation-perfusion (V/Q) imaging 3 years earlier. A SPECT V/Q scan detected a mismatched perfusion defect in the posterior basal segment of the right lower lobe, essentially unchanged from a defect identified 3 years earlier. Given the atypical finding, the patient went on to have a computed tomographic pulmonary angiogram. It revealed an intralobar bronchopulmonary sequestration as the cause of the right lower lobe mismatched perfusion defect. With growing awareness of radiation safety, the number of V/Q imaging studies being undertaken to investigate suspected pulmonary emboli, especially in young female patients, has increased. This case report serves as a timely reminder of the potential pitfalls associated with V/Q scan image interpretation.

Endobronchial embolization for life-threatening hemoptysis with Endobronchial Watanabe Spigot

BackgroundMassive hemoptysis is a common encounter in respiratory medicine. Bronchoscopy plays an important role in localizing the origin of bleeding, as well as endoscopic treatment of centrally located lesions. Endobronchial embolization is a novel technique enabling the management of hemoptysis arising even from peripheral lesions, via occlusion of the culprit bronchus, thereby securing the airway. Endobronchial Watanabe Spigot had been advocate in the treatment of bronchopleural fistula and the use of this novel technique had since then been expanded into the management of massive hemoptysis. To the best of our knowledge, this is the first reported case in Malaysia.Case presentation78-year-old lady who presented with life-threatening hemoptysis leading rapidly to cardiac arrest upon arrival. Spontaneous circulation was restored after resuscitation with an urgent thoracic computed tomography angiogram revealed bleeding likely from the posterior basal segment of left lower lobe, with bronchiectatic changes. Urgent flexible bronchoscopy revealed airway flooding, with bleeding originating from the lingular and posterior-basal segment of the left lower lobe. Airway toileting was performed and two 7 mm Endobronchial Watanabe Spigots were plugged into the culprit bronchi. Urgent bronchial artery embolization was then attempted, but was unsuccessful. She was managed conservatively, as surgical resection was deemed high risk. The spigots were removed 4 days later uneventfully. There was no recurrence of hemoptysis, and patient remained well during 1-month follow up.ConclusionsThe utmost priority in managing life-threatening hemoptysis is to prevent airway flooding. Endobronchial embolization with Endobronchial Watanabe Spigot is useful as a temporary measure before definitive therapy, or can itself be the main therapeutic player in the hemoptysis armament for high-risk patients.

Application of High-pitch CT Pulmonary Angiography at 70 kV Tube Voltage with 15 ml Contrast Medium Using Third-generation Dual-source CT.

Objective To assess the application of high-pitch CT pulmonary angiography (CTPA) at 70 kV tube voltage with 15 ml contrast medium using third-generation dual-source CT. Methods A total of 70 patients with clinically suspected pulmonary embolism were randomly divided into two groups: group A (n=35) underwent CTPA on conventional scanning mode (120 kV,80 ml contrast medium);and group B (n=35) underwent CTPA on high-pitch scanning mode at 70 kV tube voltage with 15 ml contrast medium. The CT values and standard deviations of the main pulmonary artery,apical segment of right upper pulmonary lobe (S1),and posterior basal segment of the right lower pulmonary lobe (S10),anterior thoracic air,and back muscles were measured. The signal to noise ratio (SNR),contrast to noise ratio (CNR),and effective dose (ED) were calculated. The overall image quality was evaluated by two blinded radiologists. The quality image was compared using non-parametric test on two independent samples. The potential differences in CT value,SNR,CNR,and ED were analyzed using the independent sample t-test. Results The CT values of main pulmonary artery [(300.62±77.54)HU vs.(332.80±102.80)HU;t=-1.53,P=0.13],S1 [(361.72±84.92)HU vs. (325.37±87.86)HU;t=1.81,P=0.08],and S10 [(359.54±89.61)HU vs. (318.26±87.19)HU;t=2.00,P=0.05] of right lung were not significantly different between group A and group B. The CNR of S1 (22.81±6.05 vs. 19.80±6.60;t=2.05,P=0.04) and S10 (22.65±6.37 vs. 19.28±6.63;t=2.23,P=0.03) of right lung in group A was significantly higher than in group B. The SNR of main pulmonary artery,S1,and S10 of right lung were not significantly different between group A and B. The subjective diagnostic quality values of group A and B were 1 (1,1) and 1 (1,1),respectively (Z=-0.08,P=0.93). The subjective diagnostic quality values evaluated by two radiologists showed excellent consistency(κ=0.87,P=0.01). The mean ED was 79% lower in group B [(0.92±0.23)mSv] than in group A [(4.33±1.80) mSv] (t=11.72,P=0.00).Conclusion Application of high-pitch mode in CTPA at 70 kV with 15 ml contrast medium using third-generation dual-source CT can remarkably reduce radiation dose without affecting image quality.

Veteran player tips the scale — V/Q SPECT-CT proves decisive in blunt chest trauma. Case report and brief literature review

A 29-year-old patient after blunt chest trauma with right lung atelectasis and pulmonary empyema was referred for lung ventilation and perfusion scintigraphy before right-sided pneumonectomy. Radionuclide imaging revealed severely reduced perfusion and lack of ventilation in the collapsed right lung. Additionally, it showed a matching lobar perfusion-ventilation defect in the lower left lobe, which, apart from consolidation area in posterior basal segment, appeared normal in computed tomography. A normal perfusion and ventilation pattern was observed in the upper left lobe. Since it was found to be the only functioning lobe, pneumonectomy was excluded from possible treatment options.

An Uncommon Cause for Polyuria

Diabetes Insipidus (DI) is characterized by passing of large volume of urine secondary to deficient secretion of antidiuretic hormone (Central DI) or renal resistance to its action (nephrogenic DI). Central DI is secondary to the destruction of neurons arising in the supraoptic and paraventricular nuclei [1]. The known causes include inflammatory or autoimmune diseases (e.g. sarcoidosis and Wegener’s granulomatosis), Langerhans cell histiocytosis, craniopharyngiomas, cranial injury resulting from surgery or an accident, metastases and rarely genetic defects in antidiuretic hormone synthesis. Nephrogenic DI may result from a genetic cause (e.g.: X-linked NDI is secondary to Arginine Vasopressin (AVP) receptor 2 mutations leading to a loss of function resulting in renal resistance) or an acquired cause (e.g: hypercalcaemia and medications like lithium and cisplatin) [2]. Herewith we report on a patient who presented to us with the features of diabetes insipidus. which had an abrupt onset secondary to a metastatic disease. A 31-year-old gentleman presented to Emergency Department with altered sensorium of 4 days duration. He was feeling unwell over 4 weeks prior to this presentation with an abrupt onset of polydipsia and polyuria (about 5-6 liters of urine/24 hours) along with a weight loss of 6 kg. There was no history of trauma, headache, fever, addictions, chronic illness or any long term medication use. On examination, his Glasgow Coma Scale (GCS) was 11 over 15. There was a group of matted lymph nodes (4X6 cm) in the right lower posterior cervical region. There were no signs of meningeal irritation and optic fundi examination and systemic examination were unremarkable. His haemogram and blood glucose levels were normal. The serum sodium level was 165mmol/l (135-145) with urine osmolarity of 105 mmol/kg (126-502). Other biochemical results are as follows: TSH-0.6μIU/ml (0.3 - 4.5); T4 (Total Thyroxine) -9.3ug/dL (4.5 - 12.5); FT4C (Free thyroxine)-1.3 ng/dL (0.8 - 2.0); FSH -0.7mIU/ml (0.7 – 11.1); LH -0.1 mIU/ml (0.8 – 7.6); Testosterone-20.0ng/dL (270-1030); Cortisol (8 AM) -11.6 ug/dL (7-25). The Computed Tomography [Table/Fig-1a] and MRI [Table/Fig-1b] of the brain are shown below. Histopathology from cervical lymph node biopsy and CT of the chest are shown in [Table/Fig-2,​,3]3] respectively. Both CT and the MRI brain showed a sellar-suprasellar mass lesion. The biopsy of the lymph node showed signet ring cells which were positive for CK7(Cytokeratin-7) and focally for TTF1(Transthyretin Factor-1) suggestive of an adenocarcinoma probably of the pulmonary origin (Signet Ring Cell Type). A subsequent CT of the chest showed a mass in the left lung. Thus the patient was diagnosed to have Diabetes Insipidus (DI) due to metastasis of the adenocarcinoma of the lung (signet ring cell type) with partial hypopituitarism. He was initiated on desomopressin with which his sensorium improved along with normalization of sodium and urine output. He was referred to medical oncology for further management. [Table/Fig-1]: CT and MRI Brain showing a well-defined 3.4x3.2 sized heterogeneously enhancing lesion in sellar suprasellar region [Table/Fig-2]: Histopathology (H&E) of lymph node –Signet ring cells along with increased mitotic figures suggestive of an adenocarcinoma (Signet Ring Cell Type) [Table/Fig-3]: CT Thorax–A Hypodense lobulated mass lesion in the posterior basal segment of the left lower lobe of the lung measuring 3.4 x 3.1 cm Malignancies from breast, lung, colon and prostate are the most commonest to have metastases in the pituitary gland. While most of pituitary metastases remain asymptomatic, common clinical presentation in symptomatic subjects is DI indicating preference of metastases to the posterior lobe. A CT scan usually shows a hyperdense or isodense mass which may enhance homogeneously or non-homogeneously with contrast, whereas MRI scan commonly demonstrates a high-intensity signal on T2 weighted images and the definitive diagnosis of metastatic involvement is always based on histological evaluation [2]. Management is usually palliative which includes medical treatment of diabetes insipidus and surgical debulking with or without radiotherapy especially when there is compromise of vision secondary to compression [3].

The halo sign of Q fever pneumonia

A previously healthy 29-year-old male in intimate contact with dogs presented with a five-day history of high fever, chills, headache, myalgia and nonproductive cough. He also complained of sharp right-sided chest pain worse on deep inspiration. On physical examination, the patient was febrile, tachypneic and tachycardic. Inspiratory rales were heard over the right lower lung zone. Laboratory data showed a white blood cell (WBC) count of 6.6 × 109/L with a left shift. Inflammatory markers were mildly elevated with erythrocyte sedimentation rate (ESR) 37 mm/h and C-reactive protein (CRP) 32 mg/L. A computed tomography (CT) scan of the chest revealed a 3 cm × 3 cm, well-defined and round mass surrounded by a halo of ground-glass attenuation, namely the halo sign, in the posterior basal segment of the right inferior lobe (Fig. 1). Serologic test was positive for Coxiella burnetii (C. burnetii) by indirect immunofluorescence assay (IFA). Empirical treatment was initiated with azithromycin (0.5 g daily), which was changed to doxycycline (100 mg twice a day) for 14 days. A follow-up CT scan performed four weeks later showed total resolution of the lesions. At six-month follow-up, the patient was asymptomatic with no radiological evidence of a relapse. Pneumonia is one of the cardinal manifestations of Q fever, which caused by C. burnetii infection.1 Q fever is probably the most common cause of round pneumonia in adults.2 The halo sign refers to a zone of ground-glass attenuation surrounding the circumference of a pulmonary nodule or mass on

Sudden hearing loss followed by deep vein thrombosis and pulmonary embolism in a patient with factor V Leiden mutation

Objective: Factor V Leiden (FVL) is by far the most prevalent inherited thrombophilic abnormality in Western countries, and this genetic condition has been associated with sudden sensorineural hearing loss (SSHL). Audiologists should be aware that SSHL may be the precursor of life-threatening thromboembolic events, especially in Caucasians who are more likely to be FVL carriers. Design: Case report. Study sample: A 41-year-old male patient. Results: Although this is not the first report of SSHL in a FVL carrier, it is the first to describe SSHL occurring in a heterozygous FVL carrier who — within a month — was also diagnosed with deep vein thrombosis of the left common femoral, saphenous, and popliteal veins, and pulmonary embolism of the left pulmonary artery branch serving the posterior basal segment of the inferior lobe. Conclusions: SSHL is an emergency condition that warrants prompt medical examination and treatment. Hematological investigations should be considered in SSHL patients at least for those with a family history of thrombotic events, and for women on estrogen-progestin therapy or during pregnancy, with a view to providing adequate antithrombotic prophylaxis and reducing the risk of other thromboembolic events.

Case of solitary pulmonary capillary hemangioma: Pathological features based on frozen section analysis

Solitary pulmonary capillary hemangioma (SPCH) is a rare benign lung tumor that must be distinguished from small and early lung cancers. Here, we report a case of SPCH for which we performed frozen section diagnosis. The patient was a 55-year-old Japanese woman. Five years before the operation, mixed ground-glass opacity was detected by computed tomography in the left posterior basal segment of the lower lobe (S10). Because the interior tumor density of the ground-glass opacity increased slightly, video-assisted thoracic surgery wedge resection was performed. Frozen section diagnosis revealed a benign tumor without proliferation of atypical epithelial cells. The tumor had narrow alveolar lumens, thickened alveolar septa and a clear boundary separating it from normal lung tissue. The proliferated lumens varied in size and were lined with single layers of flat cells. After the operation, immunohistochemical staining of a paraffin section revealed that the thickened alveolar septa resulted from the proliferation of capillary vessels, the flat cells of which were positive for CD31 and CD34 and negative for podoplanin; the tumor was diagnosed as SPCH. Here, we discuss the pathological features of SPCH on frozen sections with reference to this case and review previous related reports.

Analysis of atypical imaging of tuberculosis

Objective To explore the atypical imaging features of patients with pulmonary tuberculosis,in order to improve the diagnosis and differential diagnosis of pulmonary tuberculosis with atypical imaging.Methods The imaging findings of 30 cases with atypical pulmonary tuberculosis,confirmed by sputum tubercle bacillus check and antituberculous therapy tracking in our hospital from January 2010 to August 2012,were retrospectively analyzed.Results After comparative analysis of antituberculous treatment results and symptoms,the correct rate of right posterior basal segment of lower lobe and the right anterior basal segment of lower lobe lesion site was 80％.The total correct rate of imaging findings was 80％,the imaging findings and diagnosis results had positive correlation,0 ＜ r ＜ 1.Conclusion Radiographic examination of pulmonary tuberculosis with atypical lesion,the differential diagnosis of lesions in dynamic changes play an important role,master of pulmonary tuberculosis in patients with atypical imaging features,and in combination with the clinical manifestations,can effectively reduce the misdiagnosis,significantly improve the accuracy rate of imaging for atypical pulmonary tuberculosis diagnosis. Key words: Pulmonary tuberculosis; Atypical radiological appearances; Analysis

Necrotizing sarcoid granulomatosis with hemoptysis: a case report and literature review

Virtual SlidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1955868163936338We present a case of 39-year-old male with the symptoms of fever, cough, chest pain and bloody phlegm, whose chest CT showed multiple subpleural nodules and inflammatory infiltration. Video-Assisted Thoracic Surgery ( VATS ) for right subplural nodule was performed and confirmed the diagnosis of necrotizing sarcoid granulomatosis. Prednisolone was administered and the symptoms were under control untill the occurrence of intermittent hemoptysis after 10 months. Chest CT and bronchoscope revealed the right lower lobe nodule with intraluminal necrotic tissue in the right lower lobe posterior basal segment respectively. Fatal hemoptysis happened during endobronchial biopsy by flexible bronchoscope forcep. Based on this case, we reviewed the relevant literature and discussed the clinical features, pathological changes and prognosis of the disease.

Concomitant occurrence of tracheal bronchus, pulmonary sequestration and azygos lobe

A 53-year-old man was referred with the complaints of persistent cough ongoing for approximately two years with intervals, weakness and dyspnea on effort. Posteroanterior lung radiography showed normal lung parenchyma, except azygos fissure and lobe view. Fiber optic bronchoscopy demonstrated tracheal bronchus on the right lateral wall of trachea, 2.5-3 cm above the main carina. Thoracic computed tomography revealed a view in soft-tissue density located in the left lung posterior basal segment, sized 4x2.5 cm, which had an aberrant arterial supply originating from thoracic aorta and was consistent with intralobar pulmonary sequestration. We present this case with a literature review, as we did not find any other case having all these three anomalies together in the literature search.

Unusual presentation of renal vein thrombosis with pulmonary artery embolism

A young 23-year-old male patient presented with a two-day history of right flank pain. He had no history of any significant illnesses in the past. His investigations showed nephrotic range proteinuria with hypoalbuminemia. The patient developed cough and shortness of breath after having a left kidney biopsy. He did not respond to regular respiratory tract infection treatment. The kidney biopsy revealed membranoproliferative glomerulonephritis. Further investigations for the cough showed thromboembolism of the posterior and lateral basal segments of the right lower lobe. Moreover he was found to have thrombosis of the right upper pole renal vein. The patient was started on full anticoagulation along with three days pulse steroid, followed by 1 mg/kg oral steroid. Clinical improvement was noticed within 48 h. After eight weeks the proteinuria decreased from 8.5 gm/day to 1.1 gm/day. The kidney function was normal with eGFR 145 mL/min through the course of the disease. This case represent one of the unusual presentation of nephrotic syndrome with pulmonary and renal vascular thromboembolic events. The response to the combination of anticoagulation and steroid was remarkable.

HYDATID CYST OF THE LEFT LUNG LOWER LOBE PRESENTING WITH ABDOMINAL PAIN

Hydatid cyst is a parasitic disease which is common in our country and it stil maintains its importance nowadays. In childhood, right lung involvement is more common and hydatid cyst causes symptoms such as fever, cough, chest pain, dyspnea and hemoptysis. We reported a 10-year-old patient who presented with abdominal pain and lesion in the posterior basal segment of the left lung lower lobe compatible with hydatid cyst in thorax CT and in whom cystectomy was performed. In conclusion, in cases presenting with abdominal pain in regions where hydatid disease is endemic, hydatid cyst of the lung should be kept in mind in differential diagnosis.

Lung nodule detected by F-18 fluorodeoxyglucose positron emission tomography-computed tomography in patients with papillary thyroid cancer, negative 131I whole body scan, and undetectable serum-stimulated thyroglobulin levels: two case reports

IntroductionWhen a pulmonary nodular lesion is detected by F-18 fluorodeoxyglucose positron emission tomography-computed tomography in a patient with post-surgical papillary thyroid carcinoma with undetectable serum-stimulated thyroglobulin levels and negative 131I whole body scan, diagnosis and management of the nodule may be confusing.Case presentationWe describe two post-surgical patients with papillary thyroid carcinoma who showed pulmonary nodular lesions detected by F-18 fluorodeoxyglucose positron emission tomography-computed tomography. In both cases serum-stimulated thyroglobulin levels were undetectable and nodular lesions were not detected by 131I whole body scan. In the first case, a 64-year-old Asian woman showed one focal increased fluorodeoxyglucose uptake lesion in the right lower lobe of one of her lungs. Based on the histologic study, the pulmonary nodular lesion was diagnosed as a solitary pulmonary metastasis from papillary thyroid carcinoma. In the second case, a 59-year-old Asian woman showed a new pulmonary nodule in the right lower lobe. The computed tomography scan of her chest revealed a 9mm nodule in the anterior basal segment and another tiny nodule in the posterior basal segment of the right lower lobe. Six months later, both nodules had increased in size and miliary disseminated nodules were also seen in both lungs. Based on their histology, the pulmonary nodular lesions were considered to be primary lung adenocarcinoma.ConclusionsThe present cases emphasize that physicians should be cautious and make efforts for an accurate diagnosis of pulmonary nodules detected on F-18 fluorodeoxyglucose positron emission tomography-computed tomography in patients with papillary thyroid carcinoma with no evidence of metastasis such as negative 131I whole body scan and undetectable stimulated serum thyroglobulin levels.

EVALUATION OF LEFT VENTRICAL FUNCTION BY TWO-DIMENSIONAL LONGITUDINAL STRAIN IN PATIENTS WITH FAMILIAL HYPERCHOLESTEROLAEMIA

ObjectivesTo evaluate the left ventricular function of global and each section through left ventricular longitudinal strain in familial hypercholesterolaemia (FH) patients with two dimensional strain imaging (2DSI).MethodsThirty-nine patients with FH...

Video-assisted thoracic resection for intralobar pulmonary sequestration

We present a case in which video-assisted thoracic resection for intralobar pulmonary sequestration (ILPS) was successfully performed. A 36-year-old woman had repeated pneumonia. Chest computed tomography (CT) showed a round mass in the right lower lobe of the lung. Subsequent three-dimensional CT revealed that a large anomalous artery arising from the descending thoracic aorta was distributing to the posterior basal segment containing the lesion and was draining into the inferior pulmonary vein. The patient was diagnosed with ILPS and underwent surgery. The anomalous artery was divided, and the sequestered segment was completely resected by video-assisted thoracic surgery (VATS). We think that VATS resection for ILPS is feasible and is a major therapeutic option as noninvasive surgery.