array:23 [
  "pii" => "S1579212920303013"
  "issn" => "15792129"
  "doi" => "10.1016/j.arbr.2019.07.022"
  "estado" => "S300"
  "fechaPublicacion" => "2020-11-01"
  "aid" => "2256"
  "copyright" => "SEPAR"
  "copyrightAnyo" => "2019"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "sco"
  "cita" => "Arch Bronconeumol. 2020;56:745"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S1579212920303025"
    "issn" => "15792129"
    "doi" => "10.1016/j.arbr.2019.07.023"
    "estado" => "S300"
    "fechaPublicacion" => "2020-11-01"
    "aid" => "2251"
    "copyright" => "SEPAR"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "sco"
    "cita" => "Arch Bronconeumol. 2020;56:746"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>"
      "titulo" => "Rare Bronchial Tumour and an Emergent Surgery Due to Uncontrollable Haemorrhage"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "746"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Tumor bronquial infrecuente y cirug&#237;a de emergencia por hemorragia incontrolable"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Fig&#46; 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1477
              "Ancho" => 1374
              "Tamanyo" => 355808
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; Chest CT &#40;axial plan &#40;AP&#41;&#41;&#58; a 29<span class="elsevierStyleHsp" style=""></span>mm homogeneous nodular lesion in the left lower lobe&#59; &#40;B&#41; Endobronchial view of left lower lobe&#44; with a mass blocking the lateral segmental bronchus &#40;LB9&#41;&#59; &#40;C&#41; A closer view of the mass&#44; which was yellow&#44; with a smooth surface and a long implantation base&#44; containing multiple superficial vessels&#44; almost completely blocking the entrance orifice of LB9&#59; &#40;D&#41; The balloon catheter tamponade was inserted at the left common basal trunk&#59; &#40;E&#41; Microscopic examination of the surgical sample revealed tumour free margins and &#40;F&#41; formation of aggregates with plenty of plasma cells and cells having an oval to fusiform appearance&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Marta Nobre Pereira, Maria Jo&#227;o Ribeiro, Jorge Dion&#237;sio"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Marta Nobre"
              "apellidos" => "Pereira"
            ]
            1 => array:2 [
              "nombre" => "Maria Jo&#227;o"
              "apellidos" => "Ribeiro"
            ]
            2 => array:2 [
              "nombre" => "Jorge"
              "apellidos" => "Dion&#237;sio"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212920303025?idApp=UINPBA00003Z"
    "url" => "/15792129/0000005600000011/v1_202011120627/S1579212920303025/v1_202011120627/en/main.assets"
  ]
  "itemAnterior" => array:17 [
    "pii" => "S1579212920303001"
    "issn" => "15792129"
    "doi" => "10.1016/j.arbr.2019.09.019"
    "estado" => "S300"
    "fechaPublicacion" => "2020-11-01"
    "aid" => "2262"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "sco"
    "cita" => "Arch Bronconeumol. 2020;56:743-4"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>"
      "titulo" => "Complete Atrio-ventricular Block due to Cardiac Metastasis of Lung Adenocarcinoma"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "743"
          "paginaFinal" => "744"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Bloqueo auriculoventricular completo debido a met&#225;stasis card&#237;aca de un adenocarcinoma pulmonar"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Fig&#46; 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1079
              "Ancho" => 3167
              "Tamanyo" => 314625
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Transthoracic echocardiogram &#40;A&#41; and transesophageal echocardiogram &#40;B&#41; showing echogenic mass &#40;arrows&#41; located in the interatrial septum&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Saoussen Antit, Ferdaous Yangui"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "Saoussen"
              "apellidos" => "Antit"
            ]
            1 => array:2 [
              "nombre" => "Ferdaous"
              "apellidos" => "Yangui"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212920303001?idApp=UINPBA00003Z"
    "url" => "/15792129/0000005600000011/v1_202011120627/S1579212920303001/v1_202011120627/en/main.assets"
  ]
  "en" => array:13 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>"
    "titulo" => "Unusual Coexistence In Situs Inversus Totalis&#59; Right Arcus Aorta&#44; Variant Left Azygos Lobe&#44; and Aberrant Left Subclavian Artery"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:1 [
        "paginaInicial" => "745"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Veysel Ayyildiz, Fahri Aydin, Hayri Ogul"
        "autores" => array:3 [
          0 => array:3 [
            "nombre" => "Veysel"
            "apellidos" => "Ayyildiz"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Fahri"
            "apellidos" => "Aydin"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:4 [
            "nombre" => "Hayri"
            "apellidos" => "Ogul"
            "email" => array:1 [
              0 => "drhogul@gmail.com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Department of Radiology&#44; Faculty of Medicine&#44; S&#252;leyman Demirel University&#44; Isparta&#44; Turkey"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Department of Radiology&#44; Faculty of Medicine&#44; Ataturk University&#44; Erzurum&#44; Turkey"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Coincidencia Infrecuente En Un Situs Inversus Total&#59; Arco A&#243;rtico Derecho&#44; Variante L&#243;bulo Izquierdo &#193;cigo y Arteria Subclavia Izquierda Aberrante"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1132
            "Ancho" => 1149
            "Tamanyo" => 179787
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; Axial CT scan &#40;mediastinal window&#41; shows right-sided aortic arch&#46; &#40;B&#41; Axial CT scan &#40;parenchymal window&#41; reveals a variant azygos lobe on the left hemithorax and aberrant left subclavian artery&#46; &#40;D and E&#41; Coronal plan MIP CT images show total transposition of visceral organs accompanied with dextrocardia&#46; &#40;C&#44; D and F&#41; Sagittal&#44; coronal and posterolateral projection 3D CT images show aberrant left subclavian artery originated from the distal of the right aortic arc&#46; &#40;E&#41; Coronal MIP CT scan reveals origination and trace of the right and left carotid arteries&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 57-year-old female patient presented to our hospital with complaints difficulty in swallowing and coughing over the past 3 months&#46; There was no history of fever&#44; vomiting&#44; nausea&#44; or weight loss&#46; She did not report any similar episode in the past&#46; Chest X-ray showed the presence of dextrocardia&#46; Contrast enhanced computed tomography &#40;CT&#41; scan was performed for detailed evaluation the hearth and mediastinal structures&#46; The contrast enhanced CT examination showed aberrant left subclavian artery&#44; right-sided aortic arch with dextrocardia&#44; and variant azygos lobe on the left hemithorax &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#8211;F&#41;&#46; The aberrant left subclavian artery originated from the distal of the aortic arc was coursing through to posterior of the oesophagus&#46; On the CT scan was seen total transposition of visceral organs so was confirmed that the patient have situs inversus totalis &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>D and E&#41;&#46; All of visceral organs were seen on mirror image of normal locations&#46; Situs inversus totalis is a rare congenial malformation that is incidentally detected in radiological evaluations&#46; It is known as total transposition of abdominal and thoracic organs&#46; Right sided aortic arch results from regression of the left dorsal aorta in embryologic development&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">1</span></a> If the aberrant left subclavian artery is found with the right-sided aortic arch&#44; it is the last branch of the right-sided aortic arch&#46; Although right sided aortic arch may be related to aberrant left subclavian artery&#44;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">2</span></a> coincidence of situs inversus totalis and azygos lobe variant is extremely rare&#46; Right aortic arch with aberrant left subclavian artery may be accompanied dextrocardia&#46; Azygos lobe is a rare anatomic variant of right apical lobe&#44;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">3</span></a> but on our case it was seen on left side because of situs inversus&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "multimedia" => array:1 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1132
            "Ancho" => 1149
            "Tamanyo" => 179787
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; Axial CT scan &#40;mediastinal window&#41; shows right-sided aortic arch&#46; &#40;B&#41; Axial CT scan &#40;parenchymal window&#41; reveals a variant azygos lobe on the left hemithorax and aberrant left subclavian artery&#46; &#40;D and E&#41; Coronal plan MIP CT images show total transposition of visceral organs accompanied with dextrocardia&#46; &#40;C&#44; D and F&#41; Sagittal&#44; coronal and posterolateral projection 3D CT images show aberrant left subclavian artery originated from the distal of the right aortic arc&#46; &#40;E&#41; Coronal MIP CT scan reveals origination and trace of the right and left carotid arteries&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:3 [
            0 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Congenital variants and anomalies of the aortic arch"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "K&#46; Hanneman"
                            1 => "B&#46; Newman"
                            2 => "F&#46; Chan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1148/rg.2017160033"
                      "Revista" => array:6 [
                        "tituloSerie" => "Radiographics"
                        "fecha" => "2017"
                        "volumen" => "37"
                        "paginaInicial" => "32"
                        "paginaFinal" => "51"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27860551"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A right-sided aortic arch and aberrant left subclavian artery with proximal segment hypoplasia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Margolis"
                            1 => "T&#46; Bilfinger"
                            2 => "N&#46; Labropoulos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/icvts/ivr032"
                      "Revista" => array:7 [
                        "tituloSerie" => "Interact Cardiovasc Thorac Surg"
                        "fecha" => "2012"
                        "volumen" => "14"
                        "paginaInicial" => "370"
                        "paginaFinal" => "371"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22155584"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0140673617312813"
                          "estado" => "S300"
                          "issn" => "01406736"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Azygos lobe &#8211; a rare anatomical variant"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "G&#46; Pradhan"
                            1 => "S&#46; Sahoo"
                            2 => "S&#46; Mohankudo"
                            3 => "Y&#46; Dhanurdhar"
                            4 => "S&#46;K&#46; Jagaty"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.7860/JCDR/2017/29360.10455"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Diagn Res"
                        "fecha" => "2017"
                        "volumen" => "11"
                        "paginaInicial" => "TJ02"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28969244"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0091674914001080"
                          "estado" => "S300"
                          "issn" => "00916749"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15792129/0000005600000011/v1_202011120627/S1579212920303013/v1_202011120627/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "60604"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Clinical Images"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005600000011/v1_202011120627/S1579212920303013/v1_202011120627/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212920303013?idApp=UINPBA00003Z"
]
Share
Journal Information
Vol. 56. Issue 11.
Pages 745 (November 2020)
Share
Share
Download PDF
More article options
Vol. 56. Issue 11.
Pages 745 (November 2020)
Clinical Image
Full text access
Unusual Coexistence In Situs Inversus Totalis; Right Arcus Aorta, Variant Left Azygos Lobe, and Aberrant Left Subclavian Artery
Coincidencia Infrecuente En Un Situs Inversus Total; Arco Aórtico Derecho, Variante Lóbulo Izquierdo Ácigo y Arteria Subclavia Izquierda Aberrante
Visits
1330
Veysel Ayyildiza, Fahri Aydinb, Hayri Ogulb,
Corresponding author
drhogul@gmail.com

Corresponding author.
a Department of Radiology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
b Department of Radiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
This item has received
Article information
Full Text
Bibliography
Download PDF
Statistics
Figures (1)
Full Text

A 57-year-old female patient presented to our hospital with complaints difficulty in swallowing and coughing over the past 3 months. There was no history of fever, vomiting, nausea, or weight loss. She did not report any similar episode in the past. Chest X-ray showed the presence of dextrocardia. Contrast enhanced computed tomography (CT) scan was performed for detailed evaluation the hearth and mediastinal structures. The contrast enhanced CT examination showed aberrant left subclavian artery, right-sided aortic arch with dextrocardia, and variant azygos lobe on the left hemithorax (Fig. 1A–F). The aberrant left subclavian artery originated from the distal of the aortic arc was coursing through to posterior of the oesophagus. On the CT scan was seen total transposition of visceral organs so was confirmed that the patient have situs inversus totalis (Fig. 1D and E). All of visceral organs were seen on mirror image of normal locations. Situs inversus totalis is a rare congenial malformation that is incidentally detected in radiological evaluations. It is known as total transposition of abdominal and thoracic organs. Right sided aortic arch results from regression of the left dorsal aorta in embryologic development.1 If the aberrant left subclavian artery is found with the right-sided aortic arch, it is the last branch of the right-sided aortic arch. Although right sided aortic arch may be related to aberrant left subclavian artery,2 coincidence of situs inversus totalis and azygos lobe variant is extremely rare. Right aortic arch with aberrant left subclavian artery may be accompanied dextrocardia. Azygos lobe is a rare anatomic variant of right apical lobe,3 but on our case it was seen on left side because of situs inversus.

Fig. 1.

(A) Axial CT scan (mediastinal window) shows right-sided aortic arch. (B) Axial CT scan (parenchymal window) reveals a variant azygos lobe on the left hemithorax and aberrant left subclavian artery. (D and E) Coronal plan MIP CT images show total transposition of visceral organs accompanied with dextrocardia. (C, D and F) Sagittal, coronal and posterolateral projection 3D CT images show aberrant left subclavian artery originated from the distal of the right aortic arc. (E) Coronal MIP CT scan reveals origination and trace of the right and left carotid arteries.

(0.17MB).
References
[1]
K. Hanneman, B. Newman, F. Chan.
Congenital variants and anomalies of the aortic arch.
Radiographics, 37 (2017), pp. 32-51
[2]
J. Margolis, T. Bilfinger, N. Labropoulos.
A right-sided aortic arch and aberrant left subclavian artery with proximal segment hypoplasia.
Interact Cardiovasc Thorac Surg, 14 (2012), pp. 370-371
[3]
G. Pradhan, S. Sahoo, S. Mohankudo, Y. Dhanurdhar, S.K. Jagaty.
Azygos lobe – a rare anatomical variant.
J Clin Diagn Res, 11 (2017), pp. TJ02
Copyright © 2019. SEPAR
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?