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Meandering Pulmonary Vein with Accessory Fissures

Imaging findings

CT chest shows an anomalous meandering pulmonary vein in the left upper lobe connecting to the left superior pulmonary vein. Multiple well-defined accessory fissures are also present in the lower lobes, clearly demarcating the bronchopulmonary segments in a patient with Ehlers-Danlos syndrome type IV.

Key takeaways

Meandering pulmonary vein is a rare venous anomaly that mimics a vascular malformation but represents a benign drainage variant. It can co-exist with other congenital lung development variants, such as multiple accessory fissures segmenting the lower lobes.

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