During dissection practice for medical students at Nagasaki University, a horizontal fissure and hypoplastic middle lobe were encountered in the right lung of an 81-year-old Japanese female. In a normal right lung, the horizontal fissure is situated anterior to the oblique fissure. On the contrary, in the present case, the horizontal fissure was situated posterior to the oblique fissure. We identified a small, additional lobe on the medial surface of this lung. It was situated in the medial part of the oblique fissure, and was determined to be a small hypoplastic middle lobe. As a result of the hypoplasia of the middle lobe, the original horizontal fissure may have disappeared from the anterior surface. The horizontal fissure, in this case, may be a compensatory additional fissure that developed within the inferior lobe. This horizontal fissure was incomplete, both in length and depth. The left lung was normal. This case might be very rare; however, it may aid in the understanding of normal lung development. Therefore, we report this case, including its bronchial branching and vascular distribution.
KEY WORDS: Lung; Horizontal fissure of right lung; Hypoplastic middle lobe; Oblique fissure; Anomaly.