EURORAD ESR

Case 14858

The vanishing azygos vein

Author(s)
Christine Sadjo, Max Scheffler

From the Department of Radiology (C.S., M.S.),
Geneva University Hospitals,
Geneva, Switzerland.
Address correspondence to C.S.
(e-mail: christine.sadjo@hcuge.ch).
 
Patient
female, 62 year(s)
 
 
  • Figure 1
    Initial anatomical situation
     

    Frontal chest radiograph shows azygos fissure as a fine line projecting on right upper lung field (arrow). Its caudal end is continuous with the arch of the azygos vein, realizsng a teardrop-shaped opacity (arrowhead).

     
    Area of Interest: Thorax; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Congenital;

    Axial image of contrast-enhanced CT scan shows azygos vein coursing postero-anteriorly through the lowermost portion of the fissure (arrow).

     
    Area of Interest: Thorax; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Congenital;

    Nodule of the right upper lobe to be biopsied (arrow). The azygos fissure can be seen (arrowhead), separating the azygos lobe from the rest of the right upper lobe.

     
    Area of Interest: Thorax; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Congenital;
     
     
  • Figure 2
    Following biopsy

    Axial non-enhanced CT image shows right pneumothorax following fine needle biopsy. The azygos vein is now freely exposed, covered only by parietal pleura (arrowhead), whereas the azygos scissure is empty (arrow).

     
    Area of Interest: Thorax; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Congenital;
     
     
  • Figure 3
    Follow-up imaging
     

    Radiograph after chest tube placement shows reexpansion of the right lung, including the azygos lobe. The arch of the azygos vein is medially displaced in a paramediastinal position (not seen), the azygos fissure...

     
    Area of Interest: Thorax; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Congenital;

    CT image after chest tube placement and reexpansion of right lung. The azygos lobe displaces the azygos vein now medially (arrowhead), the azygos fissure (arrow) remains empty. Note small residual pneumothorax.

     
    Area of Interest: Thorax; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Congenital;
     
     
Frontal chest radiograph shows azygos fissure as a fine line projecting on right upper lung field (arrow). Its caudal end is continuous with the arch of the azygos vein, realizsng a teardrop-shaped opacity (arrowhead).
 
Axial image of contrast-enhanced CT scan shows azygos vein coursing postero-anteriorly through the lowermost portion of the fissure (arrow).
 
Nodule of the right upper lobe to be biopsied (arrow). The azygos fissure can be seen (arrowhead), separating the azygos lobe from the rest of the right upper lobe.
 
Axial non-enhanced CT image shows right pneumothorax following fine needle biopsy. The azygos vein is now freely exposed, covered only by parietal pleura (arrowhead), whereas the azygos scissure is empty (arrow).
 
Radiograph after chest tube placement shows reexpansion of the right lung, including the azygos lobe. The arch of the azygos vein is medially displaced in a paramediastinal position (not seen), the azygos fissure empty (arrow).
 
CT image after chest tube placement and reexpansion of right lung. The azygos lobe displaces the azygos vein now medially (arrowhead), the azygos fissure (arrow) remains empty. Note small residual pneumothorax.
 
 
 
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