CTICasesMeandering Top Pulmonary Vein
Imaging findings
Chest CT demonstrates an aberrant pulmonary vein (meandering top pulmonary vein) draining the right upper lobe that courses behind the right main bronchus, traverses the mediastinum, and crosses over to drain into the left superior pulmonary vein.
Key takeaways
A meandering top pulmonary vein is a rare, benign anatomical variant of pulmonary venous return that has no hemodynamic significance. Identifying this vascular variant preoperatively on CT is crucial for thoracic surgeons planning right upper lobectomies to avoid accidental transection and intraoperative hemorrhage.
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