Tumor thrombus - right inferior pulmonary vein
History of esophageal carcinoma treated by Ivor Lewis esophagectomy. Staging CT. Asymptomatic.
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Expansile filling defect in the vein as well as an intra-thoracic stomach indicative of previous Ivor Lewis resection. Confirmed filling defect (arrow) in vein on oblique sagittal reconstruction
An expansile mass in any pulmonary vessel is more likely to be tumor rather than thrombo-embolus but especially in a pulmonary vein. In this case, it appears to be a metastasis from esophageal malignancy although in most cases such an appearance is more likely to be a feature of locally advanced primary lung cancer.
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