PMC9437903_01
Contrast-enhanced CT showed that soft tissue mass-like lesions in right mediastinal and hilum of the lung with multiple tortuous vessel shadows (A); narrowed right pulmonary trunk(B); smooth left atrial wall with the absence of the right pulmonary vein(C); normal pulmonary venous drainage on the left side(D).
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Contrast-enhanced chest CT performed at our hospital confirmed a soft tissue mass-like lesions in the right mediastinal and hilum of the lung with multiple tortuous vessel shadows; the right pulmonary vein was not clearly shown; and the trunk of right pulmonary artery was obviously narrowed; the left pulmonary vein shows compensatory thickening; pleural effusion on the right side (Fig. 1).
Bronchoscopy revealed mucosal normal on the trachea and left side (A + B), while diffuse erythema of the mucosa at the entrance to the bronchus basal branch of the right lower lobe (C), and bled on contact with the bronchoscope (D).
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Bronchoscopy reveals diffuse erythema of the mucosa at the entrance to the bronchus basal branch of the right lower lobe and endobronchial ultrasound finds abundant blood vessels in the right hilar mass (Fig. 2).
Digital Sbtraction Angiography: the absence of right pulmonary veins, thickened right bronchial artery, tortuous and disordered peripheral branch vessels, and right bronchial artery pulmonary vein fistula.
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So, we further improved the diagnostic significance of the test - Digital Subtraction Angiography, and the outcome confirms the absence of right pulmonary veins (Fig. 3).