CTICasesUnilateral Pulmonary Vein Occlusion with Contralateral Pulmonary Arterial Hypertension
Imaging findings
Chest radiograph and CT show severe asymmetric volume loss, septal thickening, and peribronchial cuffing in the right lung with absent right pulmonary veins and dystrophic calcifications radiating along the hilar bronchovascular bundles. Conversely, the left lung shows mosaic attenuation, centrilobular ground-glass nodules, and massive enlargement of the left main pulmonary artery.
Key takeaways
This complex case demonstrates unilateral pulmonary vein occlusion causing localized pulmonary venous congestion, lymphatic engorgement, and calcification in the right lung, alongside contralateral severe pulmonary arterial hypertension (Eisenmenger syndrome with a VSD) in the left lung. The presence of unilateral pulmonary venous obstruction can mimic interstitial lung disease or lymphatic disorders, highlighting the importance of evaluating the pulmonary venous anatomy on cross-sectional imaging.
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