Presentation
Incidental finding on chest CT.
Patient Data
An abnormal, vertically oriented vessel drains the left upper lobe, courses superiorly lateral to the aortic arch and drains into the left brachiocephalic vein. Only one left pulmonary vein is seen draining into the left atrium. Coronal MIP image better demonstrates the anomalous vein.
Case Discussion
Partial anomalous pulmonary venous return (PAPVR) is an uncommon vascular anomaly of the lungs in which there is drainage of at least one, but not all, of the pulmonary veins into the systemic venous system or the right atrium. Its prevalence is 0.4-0.7%. These anomalies are often asymptomatic and incidentally detected on imaging. The most common variant is said to be the right superior pulmonary vein draining into the SVC or right atrium and is commonly associated with a sinus venosus ASD. Our patient has the left-sided variant in which the left superior pulmonary vein drains into the corresponding brachiocephalic vein via a vertical anomalous vein.
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