CTICasesPulmonary Artery Compression of Right Middle Lobe Bronchus in Eisenmenger Syndrome
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Imaging findings
A woman in her 40s with a known history of pulmonary hypertension, worsening cough, recurrent pneumonias, and asthma-like symptoms. A PA chest radiograph showed an enlarged left pulmonary artery and asymmetric, ovoid hilar enlargement. The lateral view revealed calcification within the pulmonary artery wall and posterior displacement of the bronchus intermedius. CT confirmed an enlarged pulmonary artery causing severe compression and abrupt occlusion of the right middle lobe bronchus, leading to atelectasis. She also had a large ventricular septal defect (VSD) and Eisenmenger Syndrome.
Key takeaways
This is a dramatic case of an enlarged pulmonary artery, a consequence of longstanding pulmonary hypertension and Eisenmenger syndrome from a VSD, causing symptomatic compression and occlusion of the right middle lobe bronchus. The calcification in the pulmonary artery wall was a key finding on both radiograph and CT, helping to distinguish it from a mass and preventing unnecessary biopsy.
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See all cases from March 11, 2015 →