CTICasesProximal Interruption of the Right Pulmonary Artery and Thymic Carcinoma
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Imaging findings
Chest CT and PET-CT demonstrate congenital absence (proximal interruption) of the right pulmonary artery, associated with significant volume loss and extensive cystic and fibrotic changes throughout the right lung. There is prominent hypertrophy of the right internal mammary and intercostal arteries, which serve as transpleural systemic-to-pulmonary collateral vessels. A separate, newly developed hypermetabolic anterior mediastinal mass is seen on PET-CT, which was subsequently resected and proven to be a thymic carcinoma.
Key takeaways
Proximal interruption of a pulmonary artery is a rare congenital anomaly that typically presents with unilateral lung volume loss, cystic or bronchiectatic changes, and extensive systemic collateralization via internal mammary, intercostal, and bronchial arteries. Patients with chronic lung disease secondary to this anomaly may be at higher risk for other thoracic pathology, and this case highlights a coincidental, unrelated development of a thymic carcinoma.
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