Anat Cell Biol.  2018 Jun;51(2):85-92. 10.5115/acb.2018.51.2.85.

Variations in human pulmonary fissures and lobes: a study conducted in nepalese cadavers

• KC S
• Shrestha P
• Shah AK
• Jha AK

• KMID: 2421171
• DOI: http://doi.org/10.5115/acb.2018.51.2.85

Abstract

The fissures of lungs are embryologically separating the bronchopulmonary segments, which later on persist in interlobar planes of fully developed lung. Fifty lungs (23 right side and 27 left side), obtained during routine dissection and preserved in formalin constituted the material for present study. In them, variations in fissures and lobes of lung were observed and compared with the previous studies. Seven right sided and 14 left sided lungs showed incomplete oblique fissure. Incomplete horizontal fissure of right lung was observed in eight lungs while it was completely missing in three specimens. A right lung with "lobe of the azygos vein" separated by a supernumerary fissure in medial surface was found. One of the right lung had both superior accessory fissure and inferior accessory fissure and four other right lungs and one left lung presented only with inferior accessory fissure. A vertical notch was found in middle lobe of one right lung. Eight left lungs exhibited with left minor fissure among them two lungs had lingula appearing as a separate lobe. Knowledge of variations in fissures and lobes is of interest to all medical professionals to exactly interpret radiographs, computed tomography scans, to diagnose, plan and modify a surgical procedure depending on the merit of the case and also in certain classical clinical cases pertaining to lung pathologies.

Keyword

Accessory; Bronchopulmonary segments; Fissures; Lobes; Lungs

MeSH Terms

Cadaver*
Formaldehyde
Humans*
Lung
Pathology
Formaldehyde

Figure

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  Fig. 1 Right lung showing complete oblique and complete horizontal fissure along with a vertical notch in middle lobe.

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  Fig. 2 Right lung showing complete oblique fissure and absent horizontal fissure.

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  Fig. 3 Medial surface of right lung showing incomplete oblique fissure and fissure separating lobe of azygos vein.

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  Fig. 4 Left lung showing complete oblique fissure, left minor fissure and accessory lobe.

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  Fig. 5 (A) Left lung showing incomplete oblique fissure. (B) Medial surface of left lung showing incomplete oblique fissure.

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  Fig. 6 Right lung showing complete oblique fissure, incomplete horizontal fissure and superior accessory fissure.

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  Fig. 7 Basal surface of right lung showing oblique fissure and inferior accessory fissure.

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  Fig. 8 Right lung showing complete oblique, complete horizontal and inferior accessory fissure along with accessory lobe.

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  Fig. 9 Medial surface of left lung showing incomplete oblique fissure, left minor fissure and lingula appearing as separate lobe.

Reference

1. Shah P, Johnson D, Standring S. Thorax. In : Standring S, editor. Gray's Anatomy: The Anatomical Basis of Clinical Practice. 39th ed. Edinburgh: Churchill Livingstone;2005. p. 1068–1069.

2. Meenakshi S, Manjunath KY, Balasubramanyam V. Morphological variations of the lung fissures and lobes. Indian J Chest Dis Allied Sci. 2004; 46:179–182. PMID: 15553206.

3. Rosse C, Gaddum-Rosse P. Hollinshed's textbook of anatomy. Philadelphia, PA: Lipincott Williams & Wilkins;1997. p. 441–461.

4. Godwin JD, Tarver RD. Accessory fissures of the lung. AJR Am J Roentgenol. 1985; 144:39–47. PMID: 3871146.

5. Zareena SK. A study of morphology and variations of lungs in adults and foetus. Int J Adv Res Technol. 2014; 3:150–157.

6. Aldur MM, Denk CC, Celik HH, Tasçioglu AB. An accessory fissure in the lower lobe of the right lung. Morphologie. 1997; 81:5–7.

7. Tarver RD. How common are incomplete pulmonary fissures, and what is their clinical significance? AJR Am J Roentgenol. 1995; 164:761.

8. Speckman JM, Gamsu G, Webb WR. Alterations in CT mediastinal anatomy produced by an azygos lobe. AJR Am J Roentgenol. 1981; 137:47–50. PMID: 6787889.

9. Nene AR, Gajendra KS, Sarma MV. Lung lobes and fissures: a morphological study. Anatomy. 2011; 5:30–38.

10. Craig SR, Walker WS. A proposed anatomical classification of the pulmonary fissures. J R Coll Surg Edinb. 1997; 42:233–234. PMID: 9276555.

11. Sadlar TW. Langman's medical embroyology. 9th ed. Baltimore, MD: Lippincott Williams & Wilkins;2004. p. 223–284.

12. Larsan WJ. Human embryology. New York: Churchill Livingstone;1993. p. 111–130. Elsevier.

13. Modgil V, Das S, Suri R. Anomalous lobar pattern of right lung: a case report. Int J Morphol. 2006; 24:5–6.

14. Hamilton WJ, Boyd JD, Mossman HW. Human embryology: prenatal development of form and function. Cambridge: W.Heffer & Sons Ltd.;1971.

15. Medlar EM. Variations in interlobar fissures. Am J Roentgenol Radium Ther. 1947; 57:723–725.

16. Lukose R, Paul S, Daniel M, Abraham SM, Alex ME, Thomans R, Nair V. Morphology of the lungs: variations in the lobes and fissures. Biomedicine. 1999; 19:227–232.

17. Bergman RA, Afifi AK, Miyauchi R. Variations in peripheral segmentation of right lung and the base of the right and left lungs [Internet]. Michael P. D'Alessandro;2008. cited 2017 Aug 1. Available from: http://www.anatomyatlases.org/AnatomicVariants/OrganSystem/Text/LungsTrachea.shtml.

18. Prakash , Bhardwaj AK, Sashirekha M, Suma HY, Krishna GG, Singh G. Lung morphology: a cadaver study in Indian population. Ital J Anat Embryol. 2010; 115:235–240. PMID: 21287979.

19. Dutta S, Mandal L, Mandal SK, Biswas J, Ray A, Bandopadhyay M. Natural fissures of lung: anatomical basis of surgical techniques and imaging. Natl J Med Res. 2013; 3:117–121.

20. Jacob SM, Pillay M. Variations in the inter-lobar fissures of lungs obtained from cadavers of South Indian origin. Int J Morphol. 2013; 31:497–499.

21. Quadros LS, Palanichamy R, D'souza AS. Variations in the lobes and fissures of lungs: a study in south Indian lung specimens. Eur J Anat. 2014; 18:16–20.

22. Lattupalli H. Lungs lobes and fissures: a morphological study. Int J Recent Trends Sci Technol. 2014; 11:122–126.

23. Magadum A, Dixit D, Bhimalli S. Fissures and lobes of lung: an anatomical study and its clinical significance. Int J Curr Res Rev. 2015; 7:8–12.

24. George BM, Nayak SB, Marpalli S. Morphological variations of the lungs: a study conducted on Indian cadavers. Anat Cell Biol. 2014; 47:253–258. PMID: 25548723.

25. Kalai A, Dhivya S. Anatomical study on variations of fissures of lung. Indian J Clin Anat Physiol. 2016; 3:449–451.

26. Dhanalakshmi V, Manoharan C, Rajesh R, Ananthi KS. Morphological study of fissures and lobes of lungs. Int J Anat Res. 2016; 4:1892–1895.

27. Mamatha Y, Murthy CK, Prakash BS. Study of morphological variations of fissures and lobes of lung. Int J Anat Res. 2016; 4:1874–1877.