Radiology Teaching Files > Case 63721

Contributed by: Faculty and residents Children's Hospital, Radiologist, Children's Health System, Birmingham, Alabama., USA.
Patient: 7 year old male
History: Patient with presumed pneumonia

Fig. 1: well-defined density projects over right heart

Fig. 2: dilatation of right upper pulmonary vein adjacent to left atrium

Fig. 3: dilatation of right upper pulmonary vein adjacent to left atrium

Fig. 4: dilatation of right upper pulmonary vein adjacent to left atrium
Findings: Well-defined round lesion of increased density identified projecting over the right heart on chest radiograph. CT demonstrates dilatation of a superior pulmonary vein on the right.
Diagnosis: Pulmonary vein varix

Pulmonary varix is a non-obstructive dilation of one or more pulmonary veins near the left atrium. It is histologically normal.

They are associated with

Acquired heart disease; usually mitral stenosis > regurgitation
Left atrial enlargement
Pulmonary venous hypertension
Rarely congenital
Radiological findings include an elongated vein in the right lower lobe (inferior pulmonary vein). On CT, the pulmonary vein would demonstrate maximum enhancement during the venous phase.

Pulmonary varix is not clinically significant. It's important not to confuse them with a mediastinal mass.


Christenson ML. The Armed Forces Institute of Pathology Lecture Series: Benign lesions of the lung.
Chilton SJ and Campbell JB. Pulmonary varix in early infancy: case report with 8-year follow up. Radiology. 1978; 129: 400.

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Additional Details:

Case Number: 63721Last Updated: 2010-12-02
Anatomy: Heart   Pathology: Congenital
Modality: CTAccess Level: Readable by all users
Keywords: pulmonary vein varix; brenda grabbACR: 6.1494

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