An aberrant anterior lobe and unusual accessory fissure of the left lung in human — anatomical and clinical considerations

Abstract Introduction Refinements in the modern computed tomography (CT) imaging techniques have led to anatomical variations in the fissures of lung being diagnosed more frequently. So far, majority of the studies conducted are cadaveric. There is paucity of studies in this aspect based on chest CT images. Hence, we undertook this study to find the anatomical variations in the fissures. Prior detection of anatomical abnormalities is important to reduce postoperative complications in lung resection surgeries. Materials and Methods This was a cross-sectional study conducted over a period of 2 years. Data were collected from the patients who underwent CT scan thorax. Patients in whom normal anatomy of lung was distorted and cases where both lungs were not visualized completely were excluded from the study. All the CT images were reviewed by a single radiologist. The presence or absence of the normal and accessory pulmonary fissures, as well as the continuity of each fissure, was recorded by the radiologist. Data were compiled and analyzed. Results The study population consisted of 394 (70.4%) males and 166 (29.6%) females, totaling 560 cases. Fissural variations were detected in 22.9% (n = 128). Also, 17.5% (n = 98) fissural variations were seen in males and 5.4% (n = 30) fissural variations were seen in females. Further, 54.7% (n = 70) of variations were detected in the right lung and 45.3% (n = 58) in the left lung. The most common fissural variation noted was right incomplete oblique fissure with a frequency of 8.4% cases (n = 47). The most common accessory fissure detected was inferior accessory fissure. Total 22 cases were detected in both the lungs, 17 cases in male and 5 in female. Conclusion Anatomical variations in fissures were found to be more in the right lung than the left lung. Accessory fissures were detected in higher incidence on the right side.

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Mycoplasma pneumoniae infection mimicking tuberculous pleurisy in a young woman: a case report and literature review

Journal of International Medical Research ◽

10.1177/0300060520918701 ◽

2020 ◽

Vol 48 (4) ◽

pp. 030006052091870

Author(s):

Peng Wen ◽

Min Wei ◽

Xue Guo ◽

Yu-Rong Xu

Keyword(s):

Pleural Effusion ◽

Adenosine Deaminase ◽

Mycoplasma Pneumoniae ◽

Left Lung ◽

Lower Lobe ◽

Anterior Lobe ◽

Immunoglobulin M ◽

Recent Infection ◽

History Of ◽

Tuberculous Pleurisy

A 30-year-old woman was admitted to a different hospital with a 2-day history of fever, cough, and expectoration. She had a history of left pulmonary tuberculosis 8 years previously. Chest computed tomography showed an infiltrate in the inferior lobe of the left lung and spot-like calcifications in the anterior lobe of the upper left lobe and lower lobe of the left lung. After antibacterial treatment, the patient’s condition deteriorated and she developed significant pleural effusion on the left side. The pleural effusion assay showed a lymphocyte-predominant exudate with a significantly increased adenosine deaminase level. The patient was transferred to our hospital with a suspected diagnosis of tuberculous pleuritis. A serum test for Mycoplasma pneumoniae-specific immunoglobulin M was positive. Because of the limitations of this test in determining the occurrence of recent infection, a thoracoscopic pleural biopsy was performed, and M. pneumoniae DNA was detected in the biopsy tissue using M. pneumoniae-specific polymerase chain reaction. Thus, the patient was diagnosed with M. pneumoniae-related parapneumonic effusion. Clinicians must be aware of the usefulness and limitations of a high adenosine deaminase level and know that lymphocyte predominance in pleural effusion does not always indicate tuberculous pleurisy, especially in areas of high tuberculosis prevalence.

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Morphological Variation of Fissure and Lobe of the Left Lung: A Case Report

Acta Facultatis Medicae Naissensis ◽

10.1515/afmnai-2016-0032 ◽

2016 ◽

Vol 33 (4) ◽

pp. 307-312

Author(s):

Atoni Atoni Dogood ◽

Oyinbo Charles Aidemise ◽

Udoye Ezenwa Patrick

Keyword(s):

Case Report ◽

Morphological Variation ◽

Imaging Techniques ◽

Left Lung ◽

Anatomical Variations ◽

Segmental Resection ◽

Medical Diagnostic ◽

Oblique Fissure ◽

Accessory Fissure

Abstract The left lung usually has an oblique fissure that divides it into superior and inferior lobes. Some variants in the lobar fissure are well known, but the knowledge of certain uncommon variants will enhance our anatomical understanding and proper identification of the bronchopulmonary segments. Several imaging techniques have been used to describe anatomical variations of the lung, but studies that utilize dissections as tools for understanding lobar variations were limited. In this report, we described an incomplete horizontal fissure, bifurcated accessory fissure, incomplete superior and middle lobes, and fibrous condensation of the left lung pulmonary pleura observed during dissection. The knowledge of these anatomical variations will be useful in surgical segmental resection and lobectomy, and for accurate interpretations of medical diagnostic images.

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Fine Structural Changes in the Adenohypophyses of Rats Following Destruction of the Pituitary Stalk

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100079917 ◽

1977 ◽

Vol 35 ◽

pp. 496-497

Author(s):

K. Kovacs ◽

E. Horvath ◽

J. M. Bilbao ◽

F. A. Laszlo ◽

I. Domokos

Keyword(s):

Structural Changes ◽

Tissue Injury ◽

Anterior Lobe ◽

Uranyl Acetate ◽

Male Rats ◽

Pituitary Stalk ◽

Sequence Of Events ◽

Pituitary Glands ◽

Electrolytic Lesions ◽

Ultrathin Sections

Electrolytic lesions of the pituitary stalk in rats interrupt adenohypophysial blood flow and result in massive infarction of the anterior lobe. In order to obtain a deeper insight into the morphogenesis of tissue injury and to reveal the sequence of events, a fine structural investigation was undertaken on adenohypophyses of rats at various intervals following destruction of the pituitary stalk.The pituitary stalk was destroyed electrolytically, with a Horsley-Clarke apparatus on 27 male rats of the R-Amsterdam strain, weighing 180-200 g. Thirty minutes, 1,2,4,6 and 24 hours after surgery the animals were perfused with a glutaraldehyde-formalin solution. The skulls were then opened and the pituitary glands removed. The anterior lobes were fixed in glutaraldehyde-formalin solution, postfixed in osmium tetroxide and embedded in Durcupan. Ultrathin sections were stained with uranyl acetate and lead citrate and investigated with a Philips 300 electron microscope.

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Two Distinct Types of Microfilaments in the Cytoplasm of Human Adenohypophysial Cells

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100073787 ◽

1973 ◽

Vol 31 ◽

pp. 668-669

Author(s):

E. Horvath ◽

K. Kovacs ◽

I. E. Stratmann ◽

C. Ezrin

Keyword(s):

Pituitary Tumors ◽

Average Diameter ◽

Anterior Lobe ◽

Uranyl Acetate ◽

Type I ◽

Breast Cancer Patients ◽

Human Pituitary ◽

Severe Diabetes ◽

Pituitary Glands ◽

Membrane Bound

Surgically removed human pituitary glands as well as pituitary tumors fixed in glutaraldehyde, postfixed in osmium tetroxide, embedded in epon resin, stained with uranyl acetate and lead citrate have been investigated by electron microscopy in order to correlate ultrastructure with functional activity. In the course of this study two distinct types of microfilaments have been identified in the cytoplasm of adenohypophysiocytes.Type I microfilaments (Fig. 1) were found in the cytoplasm of anterior lobe cells of five female subjects with disseminated mammary cancer and two patients with severe diabetes mellitus. The breast cancer patients were treated pre-operatively for various periods of time with different doses of oxysteroids. The microfilaments had an average diameter of JO A, formed parallel bundles, were scattered irregularly in the cytoplasm and were frequently located in the perikaryon. They were not membrane-bound and failed to show any periodicity.

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Ultrastructural investigation of an adenoma of the pituitary post mortem

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100127542 ◽

1987 ◽

Vol 45 ◽

pp. 622-623

Author(s):

Shirley Siew ◽

W. C. deMendonca

Keyword(s):

Deleterious Effect ◽

Anterior Lobe ◽

Definitive Diagnosis ◽

Pars Intermedia ◽

Post Mortem ◽

Close Apposition ◽

Autopsy Material ◽

Progressive Loss ◽

Transmission Electron ◽

Means Of Transmission

The deleterious effect of post mortem degeneration results in a progressive loss of ultrastructural detail. This had led to reluctance (if not refusal) to examine autopsy material by means of transmission electron microscopy. Nevertheless, Johannesen has drawn attention to the fact that a sufficient amount of significant features may be preserved in order to enable the establishment of a definitive diagnosis, even on “graveyard” tissue.Routine histopathology of the autopsy organs of a woman of 78 showed the presence of a well circumscribed adenoma in the anterior lobe of the pituitary. The lesion came into close apposition to the pars intermedia. Its architecture was more compact and less vascular than that of the anterior lobe. However, there was some grouping of the cells in relation to blood vessels. The cells tended to be smaller, with a higher nucleocytoplasmic ratio. The cytoplasm showed a paucity of granules. In some of the cells, it was eosinophilic.

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