Adhesion of Lymph Node Anthracosilicosis with Pulmonary Artery:a Case Report

Abstract

Abstract Introductions; Although thoracic surgeons occasionally encounter a dense adhesion of interlobar lymph nodes with the pulmonary artery, the macroscopic features of this remain limited. Case presentation; In this report, we demonstrate the histopathological details of the adhesion. During right upper lobectomy under thoracoscopic surgery, several interlobar lymph nodes were too adherent to a posterior ascending branch of the pulmonary artery to the right upper lobe. After an unplanned conversion to thoracotomy in order to avoid massive bleeding, the branch of the pulmonary artery was divided safely. Microscopic examination revealed that anthracosilicosis in interlobar lymph nodes presented fibrotic nodules and adventitial stroma of the pulmonary artery, which contacted with lymph node anthracosilicosis and developed into dense and borderless fibrous tissue with variable numbers of dust-laden macrophages. Conclusions; Our findings suggest that it was too delicate a surgery to dissect adventitia of the pulmonary artery in contact with lymph node silicosis using regular maneuvers. Therefore, this case can help gain a greater understanding of the risk of forced adhesiolysis and contribute to increased safety when addressing the problem.