Presentation
Cough
Patient Data
Chest radiograph shows multiple left perihilar nodular opacities.
Contrast-enhanced CT demonstrates a tubular vascular structure arising from the left pulmonary vein without abnormal connection to the pulmonary arterial vasculature.
Injection from the main pulmonary artery shows delayed opacification of multiple tortuous pulmonary veins. No early venous opacification or abnormal communication between the pulmonary arterial vasculature and pulmonary veins.
Case Discussion
A pulmonary varix is a rare entity where the pulmonary vein is abnormally dilated or tortuous but has normal drainage into the left atrium. The morphology of a pulmonary varix can either be saccular, tortuous - as in this case - or, confluent. Pulmonary varices can either be acquired, or congenital and are associated with other cardiac defects as well as Klippel-Trenaunay-Weber Syndrome.
While most pulmonary varices are asymptomatic, some patients can present with cough, shortness of breath, or stroke.
This was a case of a congenital pulmonary varix. The patient's cough was found to be unrelated to her varix, and resolved without treatment.
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