Multiple pulmonary arteriovenous malformations with background hereditary hemorrhagic telangiectasia

Case contributed by Andrew Dixon
Diagnosis almost certain

Presentation

Recurrent nose bleeds.

Patient Data

Age: 12 years
Gender: Male
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Info

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.

This study is a stack
Axial C+
arterial phase
This study is a stack
Coronal C+
arterial phase
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Info

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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