Pulmonary venous anomalies causing misdiagnosis of pulmonary arteriovenous malformations

Abstract

Purpose: To investigate pulmonary venous anomaly as a cause of pulmonary arteriovenous malformation (PAVM) misdiagnosis.

Materials and methods: We reviewed adult patients within a 7.5-year period with CT scans initially diagnosed with PAVM and subsequent conventional pulmonary angiograms.

Results: Pulmonary arteriography showed no PAVM on arterial phase for 10 out of 99 patients, comprising the misdiagnosed group. Four misdiagnosed patients had pulmonary venous anomalies and six had nodular lesions on CT.

Conclusion: Pulmonary venous anomalies are vascular mimics of PAVMs that may lead to misdiagnosis. Optimal CT technique and careful imaging review are necessary to minimize inappropriate invasive angiography.

Keywords: Anomalous single unilateral pulmonary vein; Computed tomography; Meandering vein; Pulmonary angiography; Pulmonary arteriovenous malformation.