Uniportal video-assisted thoracoscopic fissureless right upper lobe anterior segmentectomy for inflammatory myofibroblastic tumor: A case report

Figure 1 Preoperative imaging studies. A: Chest radiograph showing a solitary pulmonary nodule of the right hilar area (orange arrow); B and C: Similar findings are observed on chest computed tomography (axial and sagittal views), with the nodule situated in the anterior segment of the right upper lobe.

Figure 2 Operative views of the segmentectomy. A: A solid, round, and mobile pulmonary nodule is observed; however, there is no minor fissure; B: The anterior segmental artery (A3) and bronchus (B3) are identified (white arrows); C: The resected anterior segment of the right upper lobe, with visible vascular and bronchial stumps (orange arrow).

Figure 3 Right upper lobe stumps at the resection line. A: Anterior segmental veins (V³b and V³a) are clearly visible; B: The surgical edge at the completion of uniportal video-assisted thoracoscopic right upper lobe anterior segmentectomy.

Figure 4 Postoperative findings. A: A clear upright film (anteroposterior) acquired in the recovery room; B: Image of the gross specimen revealing a well-demarcated, unencapsulated, yellowish-gray mass without necrosis, measuring 2.2 cm × 2.0 cm. This solitary pulmonary nodule was situated in close proximity to the anterior segmental bronchus of the right upper lobe.

Figure 5 Microscopic morphology. A: Microscopic examination showing a hypercellular nodule comprising spindle-shaped cells arranged in a fascicular growth pattern; B: At higher magnification, plump spindle cell proliferation is observed, interspersed with chronic inflammatory cells; C: Immunohistochemically, the spindle cells exhibit diffuse and strong positivity for anaplastic lymphoma kinase ventana anti-anaplastic lymphoma kinase.