Multiple pulmonary arteriovenous malformations with background hereditary hemorrhagic telangiectasia

Case contributed by Dr Andrew Dixon

Presentation

Recurrent nose bleeds.

Patient Data

Age: 12 years
Gender: Male

Multiple pulmonary nodules are seen on the chest radiograph, the largest in the right mid-zone.  There is a prominent vessel leading to this nodule.

Intravenous contrast enhanced CT demonstrates multiple pulmonary arteriovenous malformations ranging in size from small to moderately large.

Case Discussion

The multiplicity of AVMs and history of epistaxis suggests hereditary hemorrhagic telangiectasia (HHT), also known as Osler-Weber-Rendu syndrome.

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