A rare cadaveric report of the azygos lobe of the right lung

Yıl 2023, Cilt: 17 Sayı: 1, 41 - 44, 30.04.2023

Aditya Srinivasan Robert-louis Hollingsworth Natalia Lowry Jeffrey Fahl Michael P. Smith Amanda S. Khan

Öz

Variations in the vessels of the mediastinum may cause unexpected complications during thoracic procedures. In this report, we show a rare variation of the azygos vein resulting in an azygos lobe of the right lung in a female cadaver. During routine dissection of the superior mediastinum in a white female cadaver, a variation in the venous anatomy was observed and documented. Further dissection of the middle and posterior mediastinum was performed to follow the course of the anomalous vein, and the right lung was removed. The observed anomalous vein was discovered to be a variation of the azygos vein which arched around the superior lobe of the right lung to unite with the superior vena cava resulting in an azygos lobe of the right lung. Variations in the anatomy of the azygos venous system are not uncommon, and azygos lobes of the right lung are commonly reported as incidental findings on imaging, but not often in cadavers. While individuals with this type of variation are unlikely to present clinically, documenting unusual vascular anatomy of the mediastinum is of interest to avoid unnecessary procedures and unexpected complications during thoracic surgery.

Anahtar Kelimeler

anatomical variation, azygos lobe, azygos vein, posterior mediastinum

Kaynakça

• Piciucchi S, Barone D, Sanna S, Dubini A, Goodman LR, Oboldi D, Bertocco M, Ciccotosto C, Gavelli G, Carloni A, Poletti V. The azygos vein pathway: an overview from anatomical variations to pathological changes. Insights Imaging 2014;5:619–28.
• Shin MS, Ho KJ. Clinical significance of azygos vein enlargement: radiographic recognition and etiologic analysis. Clin Imaging 1999; 23:236–41.
• Al-Mnayyis A, Al-Alami Z, Altamimi N, Alawneh KZ, Aleshawi A. Azygos lobe: prevalence of an anatomical variant and its recognition among postgraduate physicians. Diagnostics (Basel) 2020;10: 470.
• Bostanci K, Ozyurtkan MO, Polat MO, Batirel H, Lacin T, Yuksel M, Stamenovic D. Variations in pulmonary fissural anatomy: a medicolegal autopsy study of 256 cases. ANZ J Surg 2020;90:608–11.
• Akhtar J, Lal A, Martin KB, Popkin J. Azygos lobe: a rare cause of right paratracheal opacity. Respir Med Case Rep 2018;23:136–7.
• Liu Y, Guo D, Li J, Zhang X, He J, Huang M, Dai J, Cai H. Radiological features of azygos and hemiazygos continuation of inferior vena cava: a case report. Medicine (Baltimore) 2018;97:e0546.
• Sudikshya K, Shrestha P, Shah AK, Jha AK. Variations in human pulmonary fissures and lobes: a study conducted in Nepalese cadavers. Anat Cell Biol 2018;51:85–92.
• Rauf A, Rauf WUN, Navsa N, Ashraf KTA. Azygos lobe in a South African cadaveric population. Clin Anat 2012;25:386–90.
• Yurasakpong L, Yammine K, Limpanuparb T, Janta S, Chaiyamoon A, Kruepunga N, Meemon K, Suwannakhan A. The prevalence of the azygos lobe: a meta-analysis of 1,033,083 subjects. Clin Anat 2021;34: 872–83.
• Quraishi MB, Mufti O, Wase A. Absent left and right superior vena cava and azygos continuation of inferior vena cava: a rare anomaly of systemic venous return. J Invasive Cardiol 2010;22:159–61.
• Badagabettu SN, Shetty P, D’Souza MR. A unique variation of azygos system of veins. J Cardiovasc Echogr 2016;26):61–4.
• Petrenko VM. Development of the ascending lumbar and azygos veins in human embryogenesis. [Article in Russian] Arkh Anat Gistol Embriol 1990;98: 65–70.
• Dudiak CM, Olson MC, Posniak HV. CT evaluation of congenital and acquired abnormalities of the azygos system. Radiographics 1991; 11:233–46.
• Denega T, Alkul S, Islam E, Alalawi R. Recurrent hemoptysis – a complication associated with an azygos lobe. The Southwest Respiratory and Critical Care Chronicles 2015;3:44–7.
• Darlong LM, Ram D, Sharma A, Sharma AK, Iqbal SA, Nagar A, Hazarika D. The azygous lobe of the lung: in the case of lung cancer. Indian J Surg Oncol 2017;8:195–7.