Anatomical changes after pneumonectomy

Pneumonectomy is associated with many diverse post-operative conditions, e.g. hydropneumothorax, diaphragm elevation, progressive mediastinal displacement, thorax wall deformation, and hydrothorax. By means of imaging procedures, such pneumonectomy-related anatomical changes can easily be determined; here we summarize some of the common diagnostic findings and in addition report the case of a 100-year-old woman, who underwent left pneumonectomy at the age of 47, survived for another 53 years with only one lung and then became body donor to our department. Investigation of the cadaver revealed that, compared to similar-aged individuals still having both lungs, mediastinal structures had been displaced to the side of the missing lung. In addition, the remaining lung had herniated across the midline to a position anterior to the heart. Histological examination of the remaining lung tissue revealed changes comparable to those generally expected in lungs of individuals of the same age-group; tissue changes directly associated with pneumonectomy could not be observed. The findings document anatomical alterations that arise physiologically due to pneumectomy if no pathological complications occur.