PMC6039755_01
Axial (A) and sagittal oblique (B) reconstructions from a contrast-enhanced chest CT of Patient 1 performed at an outside hospital. Images demonstrate irregular, eccentric filling defects within the peripheral aspects of the left lower lobe pulmonary artery which appear to distort the outer contours of the artery wall (circle). Initially interpreted as consistent with thromboembolic disease, in retrospect the findings are more suggestive of in-situ pulmonary artery thrombosis in the setting of Bechet's rather than thromboembolism from deep venous thrombosis. Axial (C) and coronal oblique (D) reconstructions from a contrast-enhanced chest CT of Patient 2 performed upon initial presentation. Images demonstrate soft tissue thickening of the wall of the central systemic veins, especially the superior vena cava (SVC), which is focally narrowed at its midpoint (circle).
gr1.jpg
PMC6039755_02_gr1.jpg
fig1
However, there was now complete occlusion of the SVC with interval development of extensive venous collaterals within the anterior chest wall, along the internal mammary, azygos, hemiazygos systems, and paravertebral veins (Fig. 1C-D).
PMC6039755_02
Axial (A) and sagittal oblique (B) reconstructions from a contrast-enhanced chest CT of Patient 1 performed at an outside hospital. Images demonstrate irregular, eccentric filling defects within the peripheral aspects of the left lower lobe pulmonary artery which appear to distort the outer contours of the artery wall (circle). Initially interpreted as consistent with thromboembolic disease, in retrospect the findings are more suggestive of in-situ pulmonary artery thrombosis in the setting of Bechet's rather than thromboembolism from deep venous thrombosis. Axial (C) and coronal oblique (D) reconstructions from a contrast-enhanced chest CT of Patient 2 performed upon initial presentation. Images demonstrate soft tissue thickening of the wall of the central systemic veins, especially the superior vena cava (SVC), which is focally narrowed at its midpoint (circle).
gr1.jpg
PMC6039755_02_gr1.jpg
fig1
However, there was now complete occlusion of the SVC with interval development of extensive venous collaterals within the anterior chest wall, along the internal mammary, azygos, hemiazygos systems, and paravertebral veins (Fig. 1C-D).