CTICasesMeandering Pulmonary Vein with Congenital Right Isomerism
Imaging findings
High-resolution chest CT shows tortuous, unusually running pulmonary veins (meandering pulmonary veins) that meander through the parenchyma but drain normally into the left atrium. Sagittal and coronal reformats show that the left pulmonary artery does not loop over the left main bronchus, which, along with an accessory/minor fissure on the left, confirms a bilateral right lung branching pattern (right isomerism).
Key takeaways
Meandering pulmonary veins are rare, benign congenital vascular anomalies where pulmonary veins run a tortuous course through the lungs but still drain normally into the left atrium (unlike scimitar syndrome). The presence of such vascular anomalies should prompt a careful search for other congenital and bronchial anomalies, such as right isomerism, which is characterized by bilateral right lung anatomy and abnormal bronchial looping.
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