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KISA RAPOR
SHORT REPORT

Doi: 10.5578/tt.8132
Tuberk Toraks 2015;63(2):109-110

Geliş Tarihi/Received: 10.08.2014 • Kabul Ediliş Tarihi/Accepted: 16.09.2014

İleri yaşta bir olguda Scimitar sendromuna ait ÇKBT bulguları

Canan ALTAY1, Naciye Sinem GEZER1, Işıl BAŞARA1, Pınar BALCI1, Eyüp Sabri UÇAN2


1 Dokuz Eylül Üniversitesi Tıp Fakültesi, Radyoloji Anabilim Dalı, İzmir, Türkiye

1 Department of Radiology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey

2 Dokuz Eylül Üniversitesi Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, İzmir, Türkiye

2 Department of Chest Diseases, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey

ÖZET

İleri yaşta bir olguda Scimitar sendromuna ait ÇKBT bulguları

Scimitar sendromu sağ akciğer venöz dönüşünün anormal olarak inferior vena kavaya olduğu nadir bir vasküler anomalidir. Biz burada ileri yaşta tanı alan bir Scimitar sendromlu olguyu sunmaktayız.

Anahtar kelimeler: Scimitar sendromu, ÇKBT

SUMMARY

MDCT findings of Scimitar syndrome in an elderly patient

Scimitar syndrome is a rare congenital vascular anomaly characterized by abnormal venous drainage of the right lung to the inferior vena. We report here a case who is diagnosed late with Scimitar syndrome.

Key words: Scimitar syndrome, MDCT

INTRODUCTION

A 68-year-old woman was referred to our radiology department from chest diseases clinic with suspicion of sarcoidosis. She complained subfebrile fever and cough of a few months duration without laboratory and radiologic findings of infection. On detailed questioning, there was no history of any hemoptysis, expectoration, chest pain and extrapulmonary symptoms.

Chest X-ray showed a dilated abnormal pulmonary vascular structure (arrowheads) in right middle and lower zone (Figure 1). There was also seen irregularity of the medial right hemidiaphragm (short arrows). Axial image of contrast enhanced thorax multi detector computed tomography (MDCT) showed dilated right superior pulmonary vein (RSPV) (Figure 2, asterisk). The middle pulmonary vein also drained into RSPV (short arrows). Coronal reformatted MDCT images revealed mild right lung hypoplasia, elevation of right hemidiaphragm (short arrow) and draining the RSPV (asterisk) to the vena cava inferior (VCI) (arrowhead) (Figure 3). Volume rendering MDCT image showed relationship between RSPV (asterisk) with VCI (arrowhead) (Figure 4). There was also seen right pulmonary artery (dagger) and portal vein (short arrow). Final diagnosis of the patient was partial anomalous right pulmonary venous connection (Scimitar syndrome).


Figure 1

Figure 2

Figure 3

Figure 4

Scimitar syndrome is an uncommon vascular pathology of lung characterized by partial anomalous right pulmonary venous connection of the right pulmonary veins (1). The dilated right pulmonary vein called also "Scimitar" and usually drained to the infra-diaphragmatic VCI or hepatic veins. Scimitar syndrome has two varieties; the infantile form presents heart failure with other associated cardiac anomalies in first life of life. The adult form is usually asymptomatic and not associated with other cardiac disorders (2). The major clinic findings are hemoptysis and pulmonary arterial hypertension. Additionally, right lung hypoplasia, dextrocardia and anomalous systemic arterial supply from aorta to the right lung may be isolated.

CONFLICT of INTEREST

None declared.

REFERENCES

  1. Siu CW, Cheung SC, Chan CW, Lam YM, Tse HF, Jim MH. Scimitar syndrome on chest X ray. Postgrad Med J 2008;84:558. doi:10.1136/pgmj.2008.070375.
  2. Frydrychowicz A, Landgraf B, Wieben O, François CJ. Images in Cardiovascular Medicine. Scimitar syndrome: added value by isotropic flow-sensitive four-dimensional magnetic resonance imaging with PC-VIPR (phase-contrast vastly undersampled isotropic projection reconstruction). Circulation 2010;121:e434-6.

Yazışma Adresi (Address for Correspondence)

Dr. Canan ALTAY

Dokuz Eylül Üniversitesi Tıp Fakültesi,

Radyoloji Anabilim Dalı,

Mithatpaşa Cad.

İnciraltı İZMİR - TURKEY

e-mail: cananaltay@yahoo.com

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