Clinical history

Case 99


26-year-old man.
Routine chest-radiograph.
No previous medical history.
Clinical examination revealed deformity of the chest wall with a small right hemithorax.

Radiological images


Radiological findings


CT images

CT findings

Extra Examinations



None.

Final diagnosis


Right partial anomalous venous return draining the right upper lobe into the IVC, corresponding to a Scimitar Syndrome, due to similarity between the anomalous pulmonary vein and the Middle East sword.

The scimitar syndrome often includes a spectrum of associated anomalies :
abnormal lobation of the right lung with mediastinal shift to the right, also called hypogenetic right lung syndrome
dextroposition of the heart pulmonary arterial anomalies (small ipsilateral pulmonary artery in half of patients)
systemic arterial supply originating from the abdominal aorta and less frequently from thoracic descending aorta other tracheal or bronchial malformations (cysts or diverticula, bronchiectasis in up to 14%)
accessory hemidiaphragm, diaphragmatic eventration
horseshoe lung
other cardiovascular anomalies in 25%, most frequentlyinteratrial communication

In this case, the following anomalies were mainly or exclusively demonstrated on CT:



References:
Benoît Ghaye and Thierry Couvreur. Partial anomalous venous return. In: M Remy-Jardin and J Remy Eds. Integrated cardio-pulmonary imaging with MDCT. Medical Radiology. Springer Heidelberg 2009. p 307-324

Dupuis C, Charaf LA, Breviere GM et al. The « adult » form of the scimitar syndrome. Am J Cardiol 1992;70:502–507

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