Presentation
Chest pain.
Patient Data
Right upper and right middle lobe nodules connected by a curvilinear opacity. Dilated aortic arch. Lungs clear, heart normal in size, no pleural effusion.
Right upper lobe peripheral pulmonary AVM , a second AVM along the minor fissure. The pulmonary artery supplying these AVMs is proximally attenuated in the suprahilar region and appears to arise directly from the main pulmonary artery.
Fusiform aneurysm of the ascending thoracic aorta and type B aortic dissection extending from the aortic isthmus distally into the abdominal aorta.The celiac artery arises from the false lumen and is stenotic at its origin. The SMA arises from the true lumen and is stenotic at its origin. The left renal artery arises from the false lumen, the right renal artery arises from the true lumen.
There is left ventricular hypertrophy. There is coronary artery calcified plaque.
Right upper lobar tracheal bronchus.
Case Discussion
In this case, the diagnosis of AVM is suggested on the plain radiograph by the curvilinear opacity connecting the 2 nodules. CT before and after contrast administration confirms the vascular nature of the nodules. Its important not to biopsy nodules with a possible arterial supply or a draining vein: in those cases a CTA may confirm an AVM.
Unable to process the form. Check for errors and try again.