CTICasesMediastinal Vascular Malformation
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Imaging findings
A patient with previous heart surgery for pulmonic stenosis shows a left main pulmonary artery that is large, and an additional opacity on radiograph. CT reveals a vascular lesion with multiple small feeding vessels, possibly containing fat centrally, and supplied by mediastinal vessels originating from a thyrocervical trunk branch. It drains into the left brachiocephalic vein and other mediastinal veins. MR confirms arterial enhancement, consistent with a vascular lesion.
Key takeaways
This case demonstrates a mixed-type vascular malformation, likely acquired given its absence in prior studies. Differential considerations included a vascular tumor such as paraganglioma, but the well-defined feeding vessel and multiple draining veins favored a malformation, potentially a hemangioma-type venous combined one, also suggested by possible fat on MR sequences.
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