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Imaging Features and Outcomes in 10 Cases of Idiopathic Azygos Vein Aneurysm  Sheung-Fat Ko, MD, Chung-Cheng Huang, MD, Jui-Wei Lin, MD, Hung-I Lu, MD,

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Presentation on theme: "Imaging Features and Outcomes in 10 Cases of Idiopathic Azygos Vein Aneurysm  Sheung-Fat Ko, MD, Chung-Cheng Huang, MD, Jui-Wei Lin, MD, Hung-I Lu, MD,"— Presentation transcript:

1 Imaging Features and Outcomes in 10 Cases of Idiopathic Azygos Vein Aneurysm 
Sheung-Fat Ko, MD, Chung-Cheng Huang, MD, Jui-Wei Lin, MD, Hung-I Lu, MD, Chia-Te Kung, MD, Shu-Hang Ng, MD, Yung-Liang Wan, MD, Hon-Kan Yip, MD  The Annals of Thoracic Surgery  Volume 97, Issue 3, Pages (March 2014) DOI: /j.athoracsur Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 (A) Chest roentgenogram of patient 1 shows large right upper mediastinal mass (arrowheads) with compression on trachea and right upper lobe of bronchus. (B) Enhanced chest CT shows slightly hyperdense but poorly enhanced right upper mediastinal mass with asymmetrical prominent lateral convexity (arrowheads) and relatively flattened medial border (open arrows). (C) T1-weighted image shows a saccular mass with eccentric lateral convex contour (arrowheads) and mildly bulging medial contour (open arrows), inhomogeneous solid core and hyperintense rim, suggestive of presence of chronic hematoma. (D) Histopathologic section shows big organized hematoma (*) occupying nearly whole venous aneurysmal sac, confirming diagnosis of thrombosed saccular azygos vein aneurysm (AVA). Note focal loss of smooth muscle (arrows) and adjacent normal smooth muscle (open arrows) along the media layer (hematoxylin and eosin, original magnification ×40). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 (A) Enhanced chest computed tomographic scan of patient 4 shows poorly enhanced azygos arch with eccentric focal dilatation over lateral part (arrowheads) and flattened medial border (open arrows), and normal adjacent azygos vein (black arrow). Note thrombi in pulmonary arterial branches (white arrows). (B) Three-year follow-up computed tomographic scan obtained because of another episode of dyspnea shows enlargement of lesion with further bulging of lateral convexity (arrowheads) and straightened medial border (open arrows), suggestive of growing saccular thrombosed azygos arch aneurysm. Note stable adjacent azygos vein (black arrow) and thrombi (white arrows) in multiple pulmonary arterial branches. Ultrasonography with Doppler evaluation showed no evidence of culprit deep vein thrombosis in pelvis and lower extremities. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 (A) Enhanced chest computed tomographic scan of patient 8 shows poorly enhanced nodule with prominent inner and outer convex borders (arrowheads) over azygos arch and adjacent poorly enhanced azygos vein (black arrow). Additional delayed scans with optimal venous enhancement in (B) axial and (C) oblique reconstruction show spindle-shaped short segmental dilatation (arrowheads) of azygos arch consistent with fusiform vein aneurysm (AVA) and adjacent normal azygos vein (black arrows). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

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