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      Pulmonary vein thrombosis in patients with medical risk factors

      case-report

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          Abstract

          Pulmonary vein thrombosis in patients with medical illnesses has been rarely reported, and it is also rarely reported in those with no risk factors. We report 2 patients with pulmonary vein thrombosis, 1 with metastatic renal cell carcinoma and 1 with presumed pulmonary aspergillosis. Thrombi or tumors in a pulmonary vein are clinically important because they may cause systemic embolism or hemoptysis.

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          Left upper lobectomy can be a risk factor for thrombosis in the pulmonary vein stump

          Kazuto Ohtaka, Yasuhiro Hida, Kichizo Kaga … (2014)
          Background Thrombosis in the left upper pulmonary vein stump after left upper lobectomy is a very rare but important complication because it occurs in the systemic circulation system. We previously made the first ever report on the frequency and risk factors of thrombosis in the pulmonary vein stump after lobectomy. In this study, we conducted an investigation in a different hospital to determine whether this was a common complication. Methods From 2008 to 2012, 151 patients who underwent lobectomy and following enhanced CT within 2 years after the operation were studied. Postoperative contrast-enhanced CT imaging was retrospectively checked. Results We found thrombosis in the pulmonary vein stump in 5 of the 151 patients (3.3%). All 5 patients underwent left upper lobectomy (17.9% of the patients who underwent left upper lobectomy). These 5 patients did not have infarction of any vital organ. The thrombus was disappeared several months later on contrast-enhanced CT in 3 patients and followed in 2 patients. On univariate analysis, there was a significant difference only in the operative procedure (p < 0.001). Conclusions Thrombosis in the pulmonary vein stump occurred with high frequency in patients who underwent left upper lobectomy. Because the frequency of thrombosis in this study was the same as in our previous report, this might be a common complication.
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            Learning from the pulmonary veins.

            Diego Varona Porres, Oscar Morenza, Esther Pallisa … (2024)
            The purpose of this article is to review the basic embryology and anatomy of the pulmonary veins and the various imaging techniques used to evaluate the pulmonary veins, as well as the radiologic findings in diseases affecting these structures. Specific cases highlight the clinical importance of the imaging features, particularly the findings obtained with multidetector computed tomography (CT). Pulmonary vein disease can be broadly classified into congenital or acquired conditions. Congenital disease, which often goes unnoticed until patients are adults, mainly includes (a) anomalies in the number or diameter of the vessels and (b) abnormal drainage or connection with the pulmonary arterial tree. Acquired disease can be grouped into (a) stenosis and obstruction, (b) hypertension, (c) thrombosis, (d) calcifications, and (e) collateral circulation. Pulmonary vein stenosis or obstruction, which often has important clinical repercussions, is frequently a result of radiofrequency ablation complications, neoplastic infiltration, or fibrosing mediastinitis. The most common cause of pulmonary venous hypertension is chronic left ventricular failure. This condition is difficult to differentiate from veno-occlusive pulmonary disease, which requires a completely different treatment. Pulmonary vein thrombosis is a rare, potentially severe condition that can have a local or distant cause. Calcifications have been described in rheumatic mitral valve disease and chronic renal failure. Finally, the pulmonary veins can act as conduits for collateral circulation in cases of obstruction of the superior vena cava. Multidetector CT is an excellent modality for imaging evaluation of the pulmonary veins, even when the examination is not specifically tailored for their assessment.
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              Pulmonary Vein Thrombosis: A Recent Systematic Review

              Gerard Chaaya, Priya Vishnubhotla (2017)
              The pulmonary veins (PVs) are the most proximal source of arterial thromboembolism. Pulmonary vein thrombosis (PVT) is a rare but potentially lethal disease; its incidence is unclear, as most of the literature includes case reports. It most commonly occurs as a complica­tion of malignancy, post lung surgery, or atrial fibrillation and can be idiopathic in some cases. Most patients with PVT are commonly asymptomatic or have nonspecific symptoms such as cough, hemoptysis, and dyspnea from pulmonary edema or infarction. The thrombi are typically detected using a variety of imaging modalities including transesophageal echocardiogram (TEE), computed tomography (CT) scanning, magnetic resonance imaging (MRI), or pulmonary angiog­raphy. Treatment should be determined by the obstructing pathological finding and can include antibiotic therapy, anticoagulation, thrombectomy, and/or pulmonary resection. The delay in diagnosing this medical entity can lead to complications including pulmonary infarction, pulmonary edema, right ventricular failure, allograft failure, and peripheral embolism resulting in limb ischemia, stroke, and renal infarction (RI).
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                Author and article information

                Contributors
                Paul D. Stein
                Journal
                Journal ID (nlm-ta): Radiol Case Rep
                Journal ID (iso-abbrev): Radiol Case Rep
                Title: Radiology Case Reports
                Publisher: Elsevier
                ISSN (Electronic): 1930-0433
                Publication date PMC-release: 13 September 2018
                Publication date Collection: December 2018
                Publication date (Electronic): 13 September 2018
                Volume: 13
                Issue: 6
                Pages: 1170-1173
                Affiliations
                [a ]Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan
                [b ]Department of Radiology, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan and Department of Radiology, St. John Hospital and Medical Center, Detroit, Michigan
                [c ]Department of Radiology, Medical College of Wisconsin/Froedtert Memorial Hospital, Milwaukee, Wisconsin
                Author notes
                [* ]Corresponding author. steinp@ 123456msu.edu
                Article
                Publisher ID: S1930-0433(18)30238-3
                DOI: 10.1016/j.radcr.2018.07.031
                PMC ID: 6140413
                SO-VID: 873c7830-d806-4a05-b9be-86cd30bbbc25
                Copyright © © 2018 The Authors
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 1 June 2018
                Date revision received : 13 July 2018
                Date accepted : 16 July 2018
                Categories
                Subject: Diagnostic Imaging

                Keywords: pulmonary vein thrombosis,aspergillosis,metastatic carcinoma
                Data availability:
                Keywords: pulmonary vein thrombosis, aspergillosis, metastatic carcinoma

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