CTICasesSystemic Arterial Supply to the Right Lower Lobe
Imaging findings
CT shows a pulmonary vein draining the right lower lobe that is larger than expected for its territory, with an adjacent area of hyperlucent lung and a funny vessel of uncertain nature. A systemic artery is seen running within the esophageal wall and giving a branch into the right lower lobe near the inferior pulmonary ligament, with adjacent bronchiectasis and scarring suggesting prior bleeding.
Key takeaways
Systemic arterial supply to a portion of otherwise normal lung is an important cause of hemoptysis because of the high systemic perfusion pressure, and a helpful tip-off is an enlarged draining pulmonary vein out of proportion to its territory. Bleeding tends to localize to the involved region, so any hemorrhage on CT helps point to the abnormal segment.
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