CTICasesMeandering Pulmonary Vein Crossing the Midline
Imaging findings
Contrast-enhanced CT demonstrates an anomalous large pulmonary vein originating from the left upper lobe. Instead of draining into the left atrium conventionally, this vessel takes a meandering course, crossing the mediastinum behind the pulmonary artery to the right side of the chest, where it joins the right superior pulmonary vein before draining back into the left atrium.
Key takeaways
A meandering pulmonary vein is a rare vascular anomaly where a pulmonary vein takes an atypical path through the lung or mediastinum. Unlike partial anomalous pulmonary venous return (PAPVR), there is no left-to-right shunt because the anomalous vein ultimately drains into the left atrium rather than systemic veins. This left-to-right crossing represents a rare mirror image of the originally described right-sided meandering vein that mimics Scimitar syndrome.
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