異常血管を伴ったcongenital pulmonary airway malformation type 1(CPAM1型)の2例  [in Japanese] Two Surgical Cases of Type 1 Congenital Pulmonary Airway Malformation Complicated with Abnormal Blood Vessels  [in Japanese]

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Author(s)

    • 古市 基彦 Furuichi Motohiko
    • 日本大学医学部心臓血管・呼吸器・総合外科学講座 Department of Respiratory Surgery, Nihon University, School of Medicine
    • 日暮 亮太 Higure Ryota
    • 日本大学医学部心臓血管・呼吸器・総合外科学講座 Department of Respiratory Surgery, Nihon University, School of Medicine
    • 大森 一光 Ohmori Kazumitsu
    • 日本大学医学部心臓血管・呼吸器・総合外科学講座 Department of Respiratory Surgery, Nihon University, School of Medicine
    • 塩野 元美 Shiono Motomi
    • 日本大学医学部心臓血管・呼吸器・総合外科学講座 Department of Respiratory Surgery, Nihon University, School of Medicine
    • 村松 高 Muramatsu Takashi
    • 日本大学医学部心臓血管・呼吸器・総合外科学講座 Department of Respiratory Surgery, Nihon University, School of Medicine
    • 四万村 三惠 Shimamura Mie
    • 日本大学医学部心臓血管・呼吸器・総合外科学講座 Department of Respiratory Surgery, Nihon University, School of Medicine
    • 西井 竜彦 Nishii Tatsuhiko
    • 日本大学医学部心臓血管・呼吸器・総合外科学講座 Department of Respiratory Surgery, Nihon University, School of Medicine
    • 馬場 都 Baba Miyako
    • 日本大学医学部麻酔科学講座 Department of Anesthesia, Nihon University, School of Medicine
    • 竹下 伸二 Takeshita Shinji
    • 日本大学医学部心臓血管・呼吸器・総合外科学講座 Department of Respiratory Surgery, Nihon University, School of Medicine
    • 田中 洋子 Tanaka Yoko
    • 日本大学医学部心臓血管・呼吸器・総合外科学講座 Department of Respiratory Surgery, Nihon University, School of Medicine
    • 諸岡 宏明 Morooka Hiroaki
    • 日本大学医学部心臓血管・呼吸器・総合外科学講座 Department of Respiratory Surgery, Nihon University, School of Medicine

Abstract

背景.CPAM(congenital pulmonary airway malformation)の1型は合併奇形が少ないとされているが,最近CPAM1型に異常血管を伴った2件の手術症例を経験したので報告する.症例.症例1は在胎30週6日で出生した女児で妊娠29週より胎児超音波で異常を指摘され,画像所見と臨床所見からCPAMが疑われ,日齢6日に右下葉切除を行った.術中所見で大動脈から右下葉に流入する異常血管を認めた.症例2は4歳女児.肺炎の遷延と嚢胞状陰影で発見された.術前精査の血管造影で部分肺静脈還流異常と異常気管支動脈を認め,左上葉切除を行った.いずれの症例も術後病理診断でCPAM1型と診断された.結語.CPAMは外科的切除が必要な疾患であり,常に肺血管異常を伴うことを十分考慮に入れて術前,術中に対応すべきと考えられた.

Background. It has been previously considered that type 1 congenital pulmonary airway malformation (CPAM) has fewer coexisting malformations; however, in this study we encountered 2 resection cases of type 1 CPAM complicated with abnormal blood vessels. Case. Case 1 was a baby who was born at 30 weeks and 6 days of gestation. From the 29th week of gestation, fetal anomaly was observed on ultrasonography. CPAM was suspected according to the imaging and clinical findings, and a right lower lobectomy was performed at 6 days of age. From the intraoperative findings, an abnormal blood vessel was observed that flowed from the aorta into the right lower lobe. Case 2 was a 4-year-old girl with prolonged pneumonia and a cystic shadow on chest radiograpy. When performing angiography during preoperative scanning, partial anomalous pulmonary venous return and an abnormal bronchial artery were observed, and a left upper lobectomy was performed. In both cases type 1 CPAM was pathologically diagnosed postoperatively. Conclusion. Because CPAM is a disorder requiring resection, we need to carefully consider the possibility of the complication of abnormal blood vessels.

Journal

  • The Journal of the Japan Society for Respiratory Endoscopy

    The Journal of the Japan Society for Respiratory Endoscopy 33(2), 119-123, 2011

    The Japan Society for Respiratory Endoscopy

References:  12

Cited by:  1

Codes

  • NII Article ID (NAID)
    110008609504
  • NII NACSIS-CAT ID (NCID)
    AN00357687
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    0287-2137
  • Data Source
    CJP  CJPref  NII-ELS  J-STAGE 
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