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Right Cardiac Bronchus: An Uncommon Incidental Finding
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Álvaro Fuentes-Martína,b,1,
, María Rosa López Pedreirac, Ángel Cilleruelo Ramosa,b
a Servicio de Cirugía Torácica, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
b Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
c Servicio de Radiología General y Radiodiagnóstico, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
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We present the incidental finding of a right cardiac bronchus (RCB) detected during the diagnostic workup of a 61-year-old woman referred for evaluation of a pulmonary nodule. The patient had no history of recurrent pulmonary infections or chronic respiratory symptoms and was asymptomatic at presentation. Chest computed tomography (CT) confirmed the presence of a pulmonary nodule in the right upper lobe, along with the incidental finding of an accessory bronchus originating from the medial wall of the bronchus intermedius and directed toward the pericardial region (Fig. 1). This finding was consistent with a right cardiac bronchus [1], a rare congenital bronchial anomaly, with an estimated incidence of less than 0.07–0.5% [2,3]. No specific treatment was required for the asymptomatic RCB. Recognition of this anatomical variant is important not only because it may occasionally cause symptoms such as recurrent infections or hemoptysis—although the majority of RCBs remain asymptomatic [3]—but also to prevent diagnostic confusion and iatrogenic injury during bronchoscopic or surgical procedures involving the bronchus intermedius.

Fig. 1.

Right cardiac bronchus: (A) Schematic representation of the tracheobronchial tree. (B) Coronal chest CT showing an accessory bronchus arising from the bronchus intermedius. (C) Axial CT confirming the bronchial trajectory toward the pericardial region.

Author contributions

Álvaro Fuentes-Martín: Conceptualization, Clinical Management, Writing – Original Draft, Supervision. María Rosa López Pedreira: Radiological Analysis, Figure Preparation, Writing – Review & Editing. Ángel Cilleruelo Ramos: Literature Review, Writing – Review & Editing.

AI declaration

During the preparation of this work, the authors used generative pre-trained transformer 4 (GPT-4) in order to check grammar and translation. After using this tool, the authors reviewed and edited the content as needed and take full responsibility for the content of the publication.

Funding

None declared.

Conflicts of interest

The authors state that they have no conflict of interests.

References
[1]
R.C. Brock.
The anatomy of the bronchial tree with special reference to the surgery of lung abscess.
(1946),
[2]
L. Sun, L. Dong, X. Jia, Y. Chen, S. Zhang, H. Zhang.
Epidemiological studies of accessory cardiac bronchus and a new variant.
Quant Imaging Med Surg, 12 (2022), pp. 4296-4303
[3]
M. Bentala, K. Grijm, J.H. van der Zee, J.J. Kloek.
Cardiac bronchus: a rare cause of hemoptysis.
Eur J Cardiothorac Surg, 22 (2002), pp. 643-645

https://www.researchgate.net/profile/Alvaro-Fuentes-Martin.

We confirm that we have obtained all consents required by applicable law for the publication of any personal details or images of patients, research subjects or other individuals that are used in the materials submitted to Elsevier. We have retained a written copy of all such consents and we agree to provide Elsevier with copies of the consents or evidence that such consents have been obtained if requested by Elsevier.

The authors published that the article is original and has not been sent to another journal for publication.

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