Online first
Case report
Published online: 2023-05-05

open access

Page views 441
Article views/downloads 315
Get Citation

Connect on Social Media

Connect on Social Media

The azygos lobe, an incidental finding in computer tomography

Ewa Toruńska1, Łukasz Klepacki1

Abstract

The azygos lobe is an anatomical variant of the upper lobe, which occurs most often in the right lung. Atypical course of the azygos vein is formed during embryogenesis, while the precursor of this vein migrates through the lung and creates the azygos fissure. Despite its rare occurrence, this variation is well described. This article presents a case of 62-year-old male with the azygos lobe, which was found accidentally in the computer tomography. The knowledge about the azygos vein is significant for surgeons, because it might reduce iatrogenic damage and help them avoid unexpected bleeding during thoracic surgery. The azygos vein might be confused with pathological conditions. It might also be associated with lung cancers, pneumothorax and congenital abnormalities. Despite the fact that the azygos lobe is well known variant, dissemination of knowledge about it is still inadequate.

Article available in PDF format

View PDF Download PDF file

References

  1. Akhtar J, Lal A, Martin KB, et al. Azygos lobe: A rare cause of right paratracheal opacity. Respir Med Case Rep. 2018; 23: 136–137.
  2. Al-Mnayyis A, Al-Alami Z, Altamimi N, et al. Azygos lobe: prevalence of an anatomical variant and its recognition among postgraduate physicians. Diagnostics (Basel). 2020; 10(7).
  3. Arai H, Inui K, Kano K, et al. Lung cancer associated with an azygos lobe successfully treated with video-assisted thoracoscopic surgery. Asian J Endosc Surg. 2012; 5(2): 96–99.
  4. Azoury FM, Sayad P. Thoracoscopic management of spontaneous pneumothorax due to azygos lobe bullae. Asian Cardiovasc Thorac Ann. 2011; 19(6): 427–429.
  5. Darlong LM, Ram D, Sharma A, et al. The azygous lobe of the lung: in the case of lung cancer. Indian J Surg Oncol. 2017; 8(2): 195–197.
  6. Fukuhara S, Montgomery M, Reyes A. Robot-assisted azygos lobectomy for adenocarcinoma arising in an azygos lobe. Interact Cardiovasc Thorac Surg. 2013; 16(5): 715–717.
  7. Kotov G, Dimitrova IN, Iliev A, et al. A Rare Case of an Azygos Lobe in the Right Lung of a 40-year-old Male. Cureus. 2018; 10(6): e2780.
  8. Krakowiak-Sarnowska E, Wiśniewski M, Szpinda M, et al. Variability of the azygos vein system in human foetuses. Folia Morphol. 2003; 62(4): 427–430.
  9. Moawad CM, Griepp DW, Moawad KA, et al. The azygos lobe of the lung. Pulmonology. 2022; 28(3): 241–242.
  10. Mpolokeng KS, Madolo MY, Louw GJ, et al. Anatomical variations in lung fissures leading to supernumerary lobes in the lungs. Transl Res Anat. 2022; 28: 100209.
  11. Ndiaye A, Ndiaye NBa, Ndiaye A, et al. The azygos lobe: an unusual anatomical observation with pathological and surgical implications. Anat Sci Int. 2012; 87(3): 174–178.
  12. Gomes Md, Nobeschi L, Dias D, et al. Analysis of the territorial pattern of the azygos venous system and its variations in fixed cadavers. Transl Res Anat. 2020; 21: 100077.
  13. Ozdemir L, Ozdemir B, Duman T. Prevalence of an azygos lobe using thoracic computed tomography. Cyprus J Med Sci. 2017; 1(3): 55–57.
  14. Pyrzowski J, Spodnik JH, Lewicka A, et al. et al.. A case of multiple abnormalities of the azygos venous system: A preaortic interazygos vein. Folia Morphol. 2007; 66(4): 353–355.
  15. Reisfeld R. Azygos lobe in endoscopic thoracic sympathectomy for hyperhidrosis. Surg Endosc. 2005; 19(7): 964–966.
  16. Rivaud Y, Maldjian PD. The azygos vein from A to Z. J Thorac Imaging. 2019; 34(5): W100–W108.
  17. Sezer HF, Abdullayev G, Avcı A, et al. Segmentectomy for primer lung cancer, which arise from azygos lobe: azygos lobectomy. Tuberk Toraks. 2019; 67(3): 231–233.
  18. Su X, Huang Q, Luo Z, et al. A rare case of right upper lung cancer with azygos lobe and partial anomalous pulmonary venous return. J Cardiothorac Surg. 2022; 17(1): 74.
  19. Tang Z, Teng Y, Li J, et al. Left upper lung cancer with persistent left superior vena cava and left azygos vein: a case report. J Cardiothorac Surg. 2020; 15(1): 254.
  20. Wang L, Zhao F, Liu H, et al. Clinical characteristics of 50 children with azygos lobe: a retrospective study. Eur J Pediatr. 2021; 180(8): 2687–2691.
  21. Yurasakpong L, Yammine K, Limpanuparb T, et al. The prevalence of the azygos lobe: a meta-analysis of 1,033,083 subjects. Clin Anat. 2021; 34(6): 872–883.