대한흉부영상의학회 Weekly Chest Cases

Case No : 186 Date 2001-05-21

Courtesy of Kyungneoyh Jeon, M.D., Duk-Sik Kang, M.D. / Kyungpook National University Hospital, Taegu, Korea
Age/Sex 64 / M
Chief ComplaintFacial and upper extremities swelling

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Diagnosis With Brief Discussion

Diagnosis: Dilated Pericardiacophrenic Vein in SVC Obstruction due to Small Cell Lung Cancer
Radiologic Findings: Contrast enhanced CT at the level of distal trachea shows an irregular mass lesion invading superior vena cava, and multiple collateral vessels in AP window including left superior intercostal vein and in the anterior chest wall.
CT scans at the level of ventricles and hepatic dome show intrathoracic course of pericardiacophrenic vein along left border of heart and its connection to inferior phrenic vein under diaphragm. Also noted are prominent azygos vein and collateral vessels in anterior chest wall.
Brief Review: The pericardiacophrenic vein drains the pericardium, pleura, and diaphragm and ascends along the left border of heart with the accompanying phrenic nerve between the mediastinal pleura and the pericardium. It drains into either the internal mammary vein or the left superior intercostal vein, or directly into the left brachiocephalic vein. Its diaphragmatic branches anastomose with those of inferior phrenic vein, which drains to the inferior vena cava or left renal vein. It could be a collateral pathway when either the superior or the inferior vena cava is obstructed. Grossly dilated pericardiacophrenic vein can cause the undulating shadow along the left cardiac border or at the cardiophrenic angle on chest radiographs.
References: 1. Godwin JD, Chen JTT. Thoracic venous anatomy. AJR 1986;147:674-684
2. Chung JW, Im JG, Park JH, Han JK, Choi CG and Han MC: Left paracardiac mass caused by dilated pericardiacophrenic vein: report of four cases. AJR 1993;160:25-28
Keywords: Mediastinum, Vascular, Vascular,

No. of Applicants : 31

▶ Correct Answer : 27/31, 87.1%

- 媛
- 怨
- 怨
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- 遺理湲곕났
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- 諛깆
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- 源
- 諛
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- 源愿
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- 異⑸④굔媛愿由ы
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- 源
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- CHU Nancy-Brabois France Denis Regent
- CHU Nancy-Brabois France JC Leclerc
- Dong-A University Hospital Ki-Nam Lee
- Matsuyama Red Cross Hospital,Matsuyama,Japan Shunya Sunami
- Ospedale di Fabriano, Italy Giancarlo Passarini
- RIPAS Hospital,BSB,Brunei Darussalam Roy Thomas
- Samsung Medical Center Tae Sung Kim
- Seoul National University Hospital Tae Jung Kim
- Stedelijk OLV Ziekenhuis Mechelen, Belgium Ivan Pilate

▶ Semi-Correct Answer : 3/31, 9.7%

- 嫄닿뎅
- 怨
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대한흉부영상의학회 Korean Society of Thoracic Radiology

Archive of Old Cases

Case No : 186 Date 2001-05-21

Discussion

No. of Applicants : 31