Right arch with aberrant left subclavian artery

Case contributed by Yi-Jin Kuok
Diagnosis certain

Presentation

Work-up of opacity seen on CXR for confusion.

Patient Data

Age: 90 years
Gender: Male

First vessel from the arch is the left commmon carotid artery. Bilateral calcified pleural plaques.
Thrombosed ligamentum arteriosum. Kommerell's diverticulum/dilatation of the origin of the left subclavian artery causes compression of the left brachiocephalic vein resulting in contrast entering the heart via alternative routes.

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