Abstract:A case of pulmonary varices with mitral valve disease is presented with a detailed review of the literature. Two distinct categories of the disease, with and without left atrial hypertension, are emphasized.
“…The confluent type of PVV is the most common type. It usually occurs at the confluences of the pulmonary veins adjacent to the left atrium [8] and is commonly associated with mitral valve disease secondary to pulmonary venous hypertension [8] , [9] , [12] . This may explain the rapid development of a varix with mitral valve prosthetic malfunction [12] .…”
Pulmonary vein varix is an unusual cause of a mediastinal mass on a chest radiograph. It may be found as an isolated malformation or as a sequela of pulmonary venous hypertension. We encountered a case presenting with left hemiparesis and a past medical history of rheumatic heart disease. The chest radiograph revealed a well-defined mediastinal mass that turned out to be a hugely dilated pulmonary vein on contrast enhanced computed tomography of the chest. The computed tomography of the brain and upper abdomen revealed bilateral cerebral infarction and splenic infarction. In the literature, one-third of the reported cases of pulmonary vein varix are acquired secondary to mitral valve disease.
“…The confluent type of PVV is the most common type. It usually occurs at the confluences of the pulmonary veins adjacent to the left atrium [8] and is commonly associated with mitral valve disease secondary to pulmonary venous hypertension [8] , [9] , [12] . This may explain the rapid development of a varix with mitral valve prosthetic malfunction [12] .…”
Pulmonary vein varix is an unusual cause of a mediastinal mass on a chest radiograph. It may be found as an isolated malformation or as a sequela of pulmonary venous hypertension. We encountered a case presenting with left hemiparesis and a past medical history of rheumatic heart disease. The chest radiograph revealed a well-defined mediastinal mass that turned out to be a hugely dilated pulmonary vein on contrast enhanced computed tomography of the chest. The computed tomography of the brain and upper abdomen revealed bilateral cerebral infarction and splenic infarction. In the literature, one-third of the reported cases of pulmonary vein varix are acquired secondary to mitral valve disease.
“…Symptomatic patients typically present with cough, dyspnea, palpitation, chest tightness, orthopnea, hemoptysis, and cerebral embolus [4], [5], [6], [7]. The cause of PVA may be congenital or posttraumatic [8], [9], [10], [11].…”
Aneurysm of a pulmonary vein is a rare vascular anomaly that is usually discovered incidentally as a pulmonary nodule or mediastinal mass. Most patients do not have any symptoms but some patients can present with dyspnea, hemoptysis, or cerebral thromboembolism. Proper diagnosis is crucial as to avoid unnecessary testing or surgical procedures. We highlight a case of an asymptomatic 59-year-old female with a pulmonary vein aneurysm presenting as a 1.5 cm right infrahilar nodule on contrast-enhanced CT during evaluation for acute cholecystitis. Further investigation with MRA revealed that it was vascular in nature, and pulmonary angiography showed dilation of the right inferior pulmonary vein with no communication to the pulmonary artery. On serial imaging, there has been no change in the size of the aneurysm. A small non-enlarging pulmonary vein aneurysm should be managed expectantly.
“…In case of haemoptysis in non-cardiac reason of the varix, lobe section can be necessary. In most cases, however, direct intervention for uncomplicated PVV is not recommended [2,5]. An appropriate diagnosis of PVV should therefore be established to prevent unnecessary thoracotomy.…”
Section: Discussionmentioning
confidence: 99%
“…Because of its resemblance to other lesions, such as malignant lung tumour, mediastinal or paramediastinal tumour [2,3], diagnostic work-up is important to avoid unnecessary investigations and surgical procedures.…”
Section: Introductionmentioning
confidence: 99%
“…
IntroductionIn the literature a pulmonary vein varix has been described as a rare lesion consisting of a focal pathological enlargement of a segment of a pulmonary vein [1,2,3,4,5]. This uncommon lesion usually presents as an asymptomatic, well-defined mediastinal or parenchymal mass on chest radiography.
The diagnosis of a pulmonary vein varix with a recently introduced new CT technology, multi-slice helical CT, is discussed. The advantage of multi-slice helical CT lies in increased thin-slice coverage during a single breath hold, which is the predominant factor limiting scan time. This CT technique facilitates the diagnosis of vascular pulmonary pathology.
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