CTICasesEnveloped Left Subclavian Artery in Severe COPD
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Imaging findings
A patient with severe chronic obstructive pulmonary disease (COPD) and hyper-expanded lungs exhibits an unusual appearance of the left subclavian artery. The vessel appears to course through the lung parenchyma and is completely enveloped by emphysematous bullae, while paradoxically remaining attached to the chest wall. The aortic arch is also noted to be somewhat elongated.
Key takeaways
This is a curious anatomical presentation where severe hyper-expansion of the lungs in COPD can cause normal structures, such as the subclavian artery, to appear aberrantly 'intrapulmonary' or 'enveloped' by bullae, despite maintaining its normal mediastinal attachments. This is an anatomical curiosity related to the extreme lung volume changes in emphysema rather than a true vascular anomaly or pathology.
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