Systemic to Pulmonary Fistulas in Hodgkin’s Disease

Abstract

Systemic to pulmonary fistula is an unusual entity and its association with hematological diseases like Hodgkin’s is extremely rare. We present a case of a 26-year-old woman with a thoracic mass and large arteriovenous fistula. The diagnosis of Hodgkin’s disease, nodular sclerosis, was obtained by a biopsy of the supraclavicular lymph node. We achieved an excellent response after combined treatment with chemotherapy, radiotherapy and arterial embolization with complete disappearance of the mass.

Multimodality Imaging Diagnostic Approach of Systemic‐to‐Pulmonary Vein Fistulae

“…Systemic‐to‐pulmonary vein fistula in patients with previous pulmonary surgery are very rare. The clinical presentations of these arteriovenous fistulae are heterogeneous, and clinical symptoms could be cough, chest pain, hemoptysis, or heart failure . Heart failure post pulmonary transplantation as a clinical presentation of systemic‐to‐pulmonary vein fistulae has never been reported in the literature.…”

“…It represents abnormal communications between intercostals arteries, lateral thoracic artery, mammary arteries, and pulmonary veins . SAPVF could be congenital or acquired . Most of the systemic‐to‐pulmonary vein fistulae are congenital.…”

“…Most of the systemic‐to‐pulmonary vein fistulae are congenital. Very rare cases of acquired SAPVF after pulmonary lobectomy, after tuberculosis, after congenital heart disease surgeries and after superior vein cava syndrome were reported . The diagnosis of SAPVF can be challenging due to variable clinical presentation .…”

“…2 SAPVF could be congenital or acquired. [2][3][4][5] Most of the systemicto-pulmonary vein fistulae are congenital. Very rare cases of acquired SAPVF after pulmonary lobectomy, after tuberculosis, after congenital heart disease surgeries and after superior vein cava syndrome were reported.…”

Pulmonary mucosa-associated lymphoid tissue lymphoma with a pulmonary arteriovenous fistula

“…There are some reports of a patient with a systemic-to-pulmonary arteriovenous fi stula associated with intrapulmonary Hodgkin's disease. [12][13][14] The physiopathology is unknown, but it is believed to be related to rapid tumor growth, which requires good blood fl ux supplied by the hypertrophied systemic circulation. Combination therapy-surgery, chemotherapy, transcatheter embolization-is performed, and good outcomes are obtained in these cases.…”