PMC6195938_01
Chest radiograph shows small volume of the right lung, mild elevation of right hemidiaphragm, absence of the mediastinal portion of the right PA (), prominent left PA and a shift of the heart, mediastinum and trachea to the right side. The left lung was hyperinflated and herniated over to the right side, as indicated by a displaced anterior junction line (). In the small right lung, there are fine reticular opacities peripherally, especially in the upper zone (). PA, pulmonary artery.
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The intrapulmonary vasculature of the left lung was normal (Figure 1).
Axial contrast-enhanced CT in the mediastinal window setting revealed prominence of the left PA and its divisions with complete absence of the mediastinal portion of the right PA [ in (a) is the expected location of the right PA]. Epicardial fat contains enlarged, contrast-enhanced intercostal collateral vessels [ in (b)]. The right internal mammary artery is enlarged [ in (a) and (b)]. PA, pulmonary artery.
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Contrast-enhanced CT (CECT) of the chest revealed dilatation of the left PA and its divisions with complete absence of the mediastinal segment of the right PA (Figures 2 and 3). In addition, branches of the dilated intercostal collateral arteries were present in the right epicardial fat (Figure 2b) and a dilated right internal mammary artery was identified in the anterior chest wall (Figure 2a,b).
Coronal reformatted images of contrast-enhanced CT chest reveals absence of the mediastinal portion of the right PA ( indicates expected location of the right PA). PA, pulmonary artery.
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Contrast-enhanced CT (CECT) of the chest revealed dilatation of the left PA and its divisions with complete absence of the mediastinal segment of the right PA (Figures 2 and 3).
CT scans in lung window setting. The fine reticular opacities within the small right lung represent transpleural collateral vessels [ in (a) and (b)]. Herniation of the hyperinflated left lung into the right hemithorax is associated with displacement of the anterior junction line. Although the right lung was small, the bronchial branching pattern was normal and there was no evidence of bronchiectasis, fibrosis or cavity.
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The small right lung demonstrated fine reticular opacification consistent with transpleural collateral arteries (Figure 4a,b).