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Pulmonary embolism with lung infarct and incidental Kommerell diverticulum

Case contributed by Ammar Haouimi
Diagnosis almost certain


Dyspnea with chest pain, and raised D-dimer.

Patient Data

Age: 85 years
Gender: Female

Total filling defect of the right main pulmonary artery and subtotal of the left main pulmonary artery, extending bilaterally into the lobar arteries and their segmental branches. A biatrial dilatation is noted. Reflux of contrast into the inferior vena cava and dilated hepatic veins with dilated azygos vein (features of right heart failure).

Triangular shaped peripheral pulmonary opacities of the right upper lobe (result of lung infarction secondary to pulmonary embolism). Mild right pleural effusion with multiple small mediastinal and hilar enlarged lymph nodes are noted. 

Right-sided aortic arch with bulbous enlargement of the left subclavian artery (Kommerell's diverticulum) at its origin from the aortic arch, posterior to the esophagus (incidental findings).

Case Discussion

Pulmonary embolism complicated by lung infarct in a patient with an incidental Kommerell diverticulum and aberrant left subclavian pulmonary artery.

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