Treatment of Systemic Arterial Supply to Lower Lobe of Left Lung (Operation vs. Embolotherapy): Comparison of Two Cases and Literature Review / 대한흉부외과학회지

Systemic arterialization of lung with/without sequestration (Sequestration/Anomalous Origin of Left Pulmonary Artery, AOLPA) is a rare form of congenital anomalous systemic arterial supply to the lungs. In this anomaly, the arterial supply of one or more arteries of the basal segments of the lower lobe derives from an aberrant vessel arising from the aorta. We report two adult cases of systemic arterialization of normal basal segments of left lower lobe lung with/without sequestration. The one (AOLPA) was treated by left lower basal segmentectomy and the other (Sequestration) by therapeutic angiographic embolization. Based on the favorable follow-up result in our patients, although lobectomy (segmentectomy) is the basic treatment modality, embolotherapy could also be a mode of treatment that could be selectively applied to elderly, infirm patients or high risk patients with poor pulmonary function.

Total anomalous pulmonary venous return(infradiaphragmatic type)

The infradiaphragmatic type of Total Anomalous Pulmonary Venous Return(TAPVR) is a rare congenital cardiacanomaly which usually results in death during the period of early infancy. A two month-old baby boy with cyanosisand respiratory distress was suspected of having a TAPVR clinically and the two-dimensional echocardiographicfindings were compatible with the infradiaphragmetic type of TAPVR. The subsequent cardiac catheterization andcineangiogram revealed the common pulmonary vein connected with portal vein and inferior vena cava in theinfradiaphragmetic area with obvious obstruction. The surgery and the autopsy confiremd the preopeative diagnosis.Among infants presenting pulmonary venous congestion in the newborn period. TAPVR below the diaphragm shold be oneof the important diagnostic cosiderations.

Sonographic diagnosis of renal masses excluding simple cyst

Sonography is quite sensitive screening method for th detection of renal mass lesions, but the specificity isrelatively low. Authors analized the sonographic findings of the confirmed 67 cases of renal masses excludingsimple cyst for possible differential points between each other. The results were as follows: 1. Among the 67cases, 44 cases(65.7%) were tumorous lesions and majority were malignant tumors. 2. Iso or hyperechoic lesions arerelatively specific finding suggestive of the tumorous lesions. 83.3% of isoechoic lesions and 85.0% ofhyperechoic lesions were tumor. 3. Tumor echogenecity of the renal cell carcinoma was variable. Of the 23 renalcell carcinomas, 10 were isoechoic, 8 were hypoechoic and 5 were hyperechoic lesions. 4. In hypoechoic lesions,findings of acoustic enhancement and wall echo were suggestive of nontumorous lesion. 5. There was no directcorrelation between echogenecity of the mass and tumor vascularity. 6. IVP findings were not sensitive andnonspecific for renal mass lesions, so ultrasound could be the initial step of diagnostic modality for evaluationof the renal mass.