CTICasesSystemic-to-Pulmonary Vein Shunting from SVC Obstruction in Treated Breast Cancer
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Imaging findings
A second patient with a history of treated breast cancer had substantial abnormality in the superior mediastinum causing SVC obstruction, with tremendous venous collaterals. Intensely opacified small veins were again seen connecting with the pulmonary veins, including a jet of contrast entering the left inferior pulmonary vein and left atrium.
Key takeaways
This second case, shown alongside the first, confirms that systemic-to-pulmonary venous shunting via collateral pathways is a reproducible consequence of SVC obstruction regardless of the underlying malignancy, with contrast directly entering the pulmonary venous system and left atrium.
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