PMC5767565_01
Principal diagnosis.. Axial computed tomography showing large right sided upper lobe lung tumour with compression of the brachiocephalic and azygos veins, superior vena cava, pulmonary artery and heart.
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The procedure was planned via a hemi-sternotomy surgical incision likely requiring cardiopulmonary bypass (CPB) due to tumour compression of the brachiocephalic and azygos veins, superior vena cava, pulmonary artery and heart (Fig. 1).
Radiological findings.. Coronal computed tomography demonstrating abrupt cut off of contrast after the profunda brachial artery.
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An urgent computed tomography angiogram was performed; arterial phase imaging of the angiogram displayed a thrombus occluding the proximal left brachial artery immediately distal to the profunda brachii branch (Fig. 2).