OBJECTIVES The B3 downwards-shifting malformation was first proposed by Boyden in 1950. Here, we report 14 cases of this malformation in the right lung and the first case of segmentectomy for this malformation. METHODS All patients with pulmonary lesions underwent three-dimensional computed tomography bronchography and angiography (3D-CTBA) between January 2019 and January 2020, prior to surgery. A consecutive 2356 patients were included, and 14 cases of this malformation were identified; bronchovascular patterns were analysed in each patient. RESULTS The incidence of this malformation was 0.6%. It was further divided into 3 types: over downwards-shift, partial downwards-shift and normal downwards-shift. The normal downwards-shift type was the most common (8/14), where B3 shifted downwards completely to merge with B4 + 5. In the partial downwards-shift (5/14), only part of the B3 shifted. In the over downwards-shift type (1/14), both B3 and B1b shifted downwards. A bifurcated right upper lobe （RUL) bronchus (B1 defective) was observed in 3 cases. The incidence of V1a, V1b, V2a, V2b, V2c, V3a, V3b and V3c was 100% (14/14). The incidence rates of A1, A3a and A3b were 100% (14/14). The incidence of A2 rec and A2 asc was 92.9% (13/14) and 71.4% (10/14), respectively. CONCLUSIONS The B3 downwards-shifting malformation or ‘Boyden’s triad’ is a rare anomaly. Anatomical exploration of this malformation is important for surgery.

中文翻译：

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博伊登三合会：过去、现在和未来

目的 B3 下移畸形于 1950 年由 Boyden 首次提出。在这里，我们报告了 14 例右肺这种畸形和首例这种畸形的肺段切除术。方法 2019 年 1 月至 2020 年 1 月期间，所有肺部病变患者在手术前均接受了三维计算机断层扫描支气管造影和血管造影（3D-CTBA）。连续纳入 2356 例患者，确定了 14 例这种畸形；对每位患者的支气管血管模式进行了分析。结果这种畸形的发生率为0.6%。进一步分为3种类型：过度下移、部分下移和正常下移。正常的向下移动类型是最常见的（8/14），其中 B3 完全向下移动以与 B4 + 5 合并。在部分向下移动 (5/14) 中，只有部分 B3 移动。在过度向下移动类型（1/14）中，B3 和 B1b 都向下移动。3例右上叶（RUL）支气管分叉（B1缺损）。V1a、V1b、V2a、V2b、V2c、V3a、V3b和V3c的发生率为100%（14/14）。A1、A3a、A3b的发生率为100%（14/14）。A2 rec 和 A2 asc 的发生率分别为 92.9% (13/14) 和 71.4% (10/14)。结论 B3 下移畸形或“Boyden 三联征”是一种罕见的异常。这种畸形的解剖学探索对手术很重要。V3b 和 V3c 为 100% (14/14)。A1、A3a、A3b的发生率为100%（14/14）。A2 rec 和 A2 asc 的发生率分别为 92.9% (13/14) 和 71.4% (10/14)。结论 B3 下移畸形或“Boyden 三联征”是一种罕见的异常。这种畸形的解剖学探索对手术很重要。V3b 和 V3c 为 100% (14/14)。A1、A3a、A3b的发生率为100%（14/14）。A2 rec 和 A2 asc 的发生率分别为 92.9% (13/14) 和 71.4% (10/14)。结论 B3 下移畸形或“Boyden 三联征”是一种罕见的异常。这种畸形的解剖学探索对手术很重要。