CTICasesAccessory Azygos Fissure
Imaging findings
High-resolution chest CT demonstrates a variation in the course of the azygos vein, which travels more superiorly than usual and drains into the right brachiocephalic vein. Along its course, a thin accessory pleural fissure is identified in the right upper lobe, ending in a small fat pad near the brachiocephalic vein, representing an accessory azygos fissure.
Key takeaways
An accessory azygos fissure is a rare congenital anatomical variant that can exist alongside or independently of a classic azygos fissure. The unusual, more superiorly located course of the azygos vein and its draining pattern into the right brachiocephalic vein can result in seemingly intrapulmonary vascular structures that should not be mistaken for pathology.
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