INTERESTING CASE DR. VIVEK PATEL, DR. VIPUL BHAVSAR.

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Presentation transcript:

INTERESTING CASE DR. VIVEK PATEL, DR. VIPUL BHAVSAR

BCG website case BCG website case 24yr old asymptomatic male patient was rejected immigration to Bahrain on the bases of X-ray chest findings which showed a right paracardiac opacity though to be infective.24yr old asymptomatic male patient was rejected immigration to Bahrain on the bases of X-ray chest findings which showed a right paracardiac opacity though to be infective. He was advised a CT scan to r/o a possible tubercular lesion.He was advised a CT scan to r/o a possible tubercular lesion. X-ray chest showed a right paracardiac curvilinear opacity. Right lung also appeared mildly hypoplastic compared to the left.X-ray chest showed a right paracardiac curvilinear opacity. Right lung also appeared mildly hypoplastic compared to the left.

HRCT

HRCT HRCT axial and coronal images show an anomalous vein in the right lung draining into the IVC. Right lung appears smaller compared to the left.HRCT axial and coronal images show an anomalous vein in the right lung draining into the IVC. Right lung appears smaller compared to the left.

Contrast enhanced CT

Anomalous vein is seen in the right lower lobe draining into the IVC.

3D SSD images

3D VRT images

Scimitar (hypogenetic lung) syndrome A rare anomaly always occuring on the right side.A rare anomaly always occuring on the right side. Typical features include : a) Hypoplasia of the right lung (seen in this case). b) hypoplasia of ipsilateral pulmonary artery. c) Anomalous pulmonary venous return (scimitar vein). d) ipsilateral mediastinal shift (evident in this case).Typical features include : a) Hypoplasia of the right lung (seen in this case). b) hypoplasia of ipsilateral pulmonary artery. c) Anomalous pulmonary venous return (scimitar vein). d) ipsilateral mediastinal shift (evident in this case).

Scimitar syndrome About 25% cases have associated cardiac anomalies like ASD and PDA.About 25% cases have associated cardiac anomalies like ASD and PDA. May have associated systemic arterial supply to the right lower lobe, which was not evident in this case.May have associated systemic arterial supply to the right lower lobe, which was not evident in this case. Symptoms: May be asymtomatic or associated with dyspnoea and recurrent lung infections. Retrospectively it was revealed that the patient had repeated lung infections in childhood.Symptoms: May be asymtomatic or associated with dyspnoea and recurrent lung infections. Retrospectively it was revealed that the patient had repeated lung infections in childhood. The term Scimitar means a Turkish sword after the shape of the anomalous vein.The term Scimitar means a Turkish sword after the shape of the anomalous vein.