1
|
Iwanaga J, Choudhury H, Yu A, Matsuo K, Kawai H, Han A, Tabira Y, Saga T, Watanabe K, Loukas M, Tubbs RS. A histological study of the adult ligamentum arteriosum: Novel findings with application to a patent ductus arteriosus. Clin Anat 2024; 37:140-146. [PMID: 37792451 DOI: 10.1002/ca.24122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/20/2023] [Accepted: 09/20/2023] [Indexed: 10/05/2023]
Abstract
The ligamentum arteriosum (LA) is the vestigial fibrous remnant of the ductus arteriosus (DA), a fetal vessel arising from the left dorsal segment of the sixth aortic arch that connects the left pulmonary artery to the aortic arch. Incomplete obliteration of the DA results in a patent ductus arteriosus (PDA), causing the shunting of oxygen-rich blood to recirculate to the lungs, which can lead to pulmonary hypertension. The current study aims to further elucidate the structural characteristics of the LA via histological analysis with data gathered from adult cadaveric specimens. The LA was harvested and histologically observed with Hematoxylin and Eosin, van Gieson, and Masson's trichrome staining. Fibrous and muscle tissues were observed in all 25 specimens. The LA was categorized into three types based on the morphological features of the LA. Type I (vessel-like structure), type II (fibrotic tissue with duct-like structure), and type III (no duct-like structure) were found in 4.0%, 80.0%, and 16.0%, respectively. Finally, the remnant of a valve in the LA was also observed at the junction between the AA and LA. We suggest that this valve be called the "pulmonary-aortic valve." In the majority of the adult LAs, a duct-like structure was still present. These data could better elucidate our understanding of the pathology and etiology of a PDA.
Collapse
Affiliation(s)
- Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Japan
- Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Japan
| | - Humza Choudhury
- Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Aaron Yu
- Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Katsuhisa Matsuo
- Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Japan
| | - Hotaka Kawai
- Department of Oral Pathology and Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Aya Han
- Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Japan
| | - Yoko Tabira
- Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Japan
| | - Tsuyoshi Saga
- Domain of Anatomy, Kurume University School of Nursing, Kurume, Japan
| | - Koichi Watanabe
- Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Japan
| | - Marios Loukas
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA
- University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
2
|
Chu XY, Cui Y, Gao Z. Ligamentum arteriosum calcification that presented as an esophageal perforation caused by duck bone ingestion. J Int Med Res 2021; 48:300060520925715. [PMID: 32425089 PMCID: PMC7238444 DOI: 10.1177/0300060520925715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Ligamentum arteriosum calcification is the calcification or ossification of
arterial ligaments. However, on computed tomography images, ligamentum
arteriosum calcification is often mistaken for esophageal perforation when a
patient has a medical history of foreign body ingestion. Ligamentum arteriosum
calcification is uncommon in clinical practice. In this case report, we confirm
the presence of this condition intraoperatively, which has seldom been reported
previously. Increased awareness of the clinical characteristics of this uncommon
disease can help thoracic surgeons with proper patient management.
Collapse
Affiliation(s)
- Xiang-Yu Chu
- Department of Thoracic Surgery, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China
| | - Yong Cui
- Department of Thoracic Surgery, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China
| | - Zhi Gao
- Department of Thoracic Surgery, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China
| |
Collapse
|
3
|
Ligamentum arteriosum calcification on paediatric postmortem computed tomography. Pediatr Radiol 2021; 51:385-391. [PMID: 33025065 DOI: 10.1007/s00247-020-04839-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 07/05/2020] [Accepted: 09/07/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Ligamentum arteriosum calcification may be a normal finding in some children, although the frequency has not been well described. OBJECTIVE To estimate the frequency of ligamentum arteriosum calcification in children at postmortem imaging. MATERIALS AND METHODS We conducted a single-centre retrospective review of paediatric postmortem CT and chest radiographic imaging over a 6-year period (January 2012 to December 2018). Two independent reviewers assessed the presence of calcification on imaging. We calculated descriptive statistical analysis of ligamentum arteriosum calcification frequency and association with age and gender. RESULTS During the study period, 220 children underwent whole-body postmortem CT and 182 underwent radiographic imaging. The frequency was higher on postmortem CT than plain radiographs (67/220, 30.5% vs. 3/182, 1.6%) and was highest in children ages 1-7 years (53.6-66.7%), with gradual reduction in frequency in older children, and none in children older than 12 years. There was no gender predilection. CONCLUSION In the postmortem setting, ligamentum arteriosum calcification is a common finding in children <8 years of age. It can be better identified on postmortem CT than chest radiographs. Radiologists new to reporting postmortem paediatric CT studies should recognise this as a common normal finding to avoid unnecessary further investigations at autopsy.
Collapse
|
5
|
Ishii H, Endo H, Kubota H. Brain infarction associate with a mobile thrombus in the aortic arch at the previous site of the ductus arteriosus. J Thorac Cardiovasc Surg 2017; 154:e1-e3. [PMID: 28259453 DOI: 10.1016/j.jtcvs.2017.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 01/04/2017] [Accepted: 01/18/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Hikaru Ishii
- Department of Cardiovascular Surgery, Kyorin University, Tokyo, Japan.
| | - Hidehito Endo
- Department of Cardiovascular Surgery, Kyorin University, Tokyo, Japan
| | - Hiroshi Kubota
- Department of Cardiovascular Surgery, Kyorin University, Tokyo, Japan
| |
Collapse
|
6
|
Kim JH, van Beek EJ, Murchison JT, Marin A, Mirsadraee S. The International Association for the Study of Lung Cancer Lymph Node Map: A Radiologic Atlas and Review. Tuberc Respir Dis (Seoul) 2015; 78:180-9. [PMID: 26175770 PMCID: PMC4499584 DOI: 10.4046/trd.2015.78.3.180] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 02/09/2015] [Accepted: 02/12/2015] [Indexed: 12/25/2022] Open
Abstract
Accurate lymph node staging of lung cancer is crucial in determining optimal treatment plans and predicting patient outcome. Currently used lymph node maps have been reconciled to the internationally accepted International Association for the Study of Lung Cancer (IASLC) map published in the seventh edition of TNM classification system of malignant tumours. This article provides computed tomographic illustrations of the IASLC nodal map, to facilitate its application in day-to-day clinical practice in order to increase the appropriate classification in lung cancer staging.
Collapse
Affiliation(s)
- Jin Hwan Kim
- Department of Radiology, Chungnam National University, School of Medicine, Daejeon, Korea
| | - Edwin Jr van Beek
- Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, UK
| | - John T Murchison
- Department of Clinical Radiology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Aleksander Marin
- Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, UK
| | - Saeed Mirsadraee
- Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, UK
| |
Collapse
|