대한흉부영상의학회 Weekly Chest Cases

Case No : 1477 Date 2026-02-09

Courtesy of Mihyun Yang / Asan Medical Center
Age/Sex 63 / F
Chief ComplaintBreast cancer, lung cance

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Diagnosis With Brief Discussion

Diagnosis: Scimitar syndrome
Radiologic Findings: Fig 1. Chest radiograph shows tubular density at right lower lung field, with equivocally decreased right lung volume.
Figs 2 and 3. Mediastinal window images of contrast-enhance chest CT show abnormal venous drainage of right lower lobe to hepatic IVC.
Figs 4-6. Lung window images of chest CT shows agenesis of RUL posterior segment.
Brief Review: Scimitar syndrome is a rare congenital anomaly characterized by partial anomalous pulmonary venous return (PAPVR) from the right lung, typically associated with right lung hypoplasia. Key anatomical featurs of scimitar syndrome include: a) aberrant venous drainage from the right lung drain abnormally into the inferior vena cava (IVC) rather than the left atrium (rarely into hepatic vein or right atrium); b) curved, vertical shadow along the right heart border in chest radiograph, known as "scimitar sign"; and c) hypoplasia of right lung
Associated anomalies are relatively common, such as systemic arterial supply to the lung, pulmonary artery hypoplasia, atrial septal defect, and diaphragmatic anomalies.
The clinical impact varies significantly based on the age of onset: In infants, symptoms often appear early and are frequently severe. Pediatric patients can be hemodynamically unstable, with mortality rates reaching as high as 45%. In adults, most cases are asymptomatic and are discovered incidentally. Emergency intervention is rarely required in this population.
References: 1. Wang, Kai, et al. "Treatment and prognosis of scimitar syndrome: a retrospective analysis in a single center of East China." Frontiers in Cardiovascular Medicine 9 (2022): 973796.
Keywords

No. of Applicants : 83

▶ Correct Answer : 80/83, 96.4%

- Funabashi General Hospital , Japan MANABU AKIMOTO
- Kyeongpook National University Hospital , Korea (South) JOHN BAEK
- Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
- , Japan Z Y
- medical scanning , Japan HIROAKI ARAKAWA
- The University of Tokyo Hospital , Japan ISSEI FUKUDA
- ZIGONG TCM HOSPITAL OF CHINA , China CAO CUN YOU
- , Japan HIROKI SAKURADA
- Shiga University of Medical Science , Japan AKITOSHI INOUE
- Kyoto University , Japan AKIHIKO SAKATA
- Central Hospital Atasehir Istanbul , Turkey ARMAGAN SARAC
- McGill University Health Center , Canada ALEXANDRE SEMIONOV
- Oita university , Japan AYUMI KAMEI
- Kyoto University Hospital , Japan YUSUKE UTSUNOMIYA
- , Korea (South) KYUNG HYUN WOO
- , Korea (South) DONG-HO BANG
- , Italy PAOLO BALDASSARI
- , France CHARLES DAMIEN
- Vita Hospital , Brazil DIOGO LAGO PINHEIRO
- , Senegal AXEL MBUYU KAYEMBE
- Other , Korea (South) SEONGSU KANG
- , Korea (South) JIN YOUNG LEE
- Kyung Hee University Medical Hospital , Korea (South) INKEON YEO
- , China FANG YING GEN
- Secomedic Hospital , Japan FUMINORI MIYOSHI
- Inje University Pusan Paik Hospital , Korea (South) GANGWON JEONG
- Seoul Medical Center , Korea (South) HYUK GI HONG
- Seoul Medical Center , Korea (South) HATAEK JEONG
- university of montreal , Canada Andrei Bogdan Gorgos I
- QATIF CENTRAL HOSPITAL , Saudi Arabia HANI M ALSALAM
- University of Yamanashi , Japan TAKAAKI HASHIMOTO
- Osaka University , Japan AKINORI HATA
- University of Yamanashi , Japan HIROYUKI MORISAKA
- Chiba University Hospital , Japan HIROKI MIYAZAKI
- Ajou University Hospital , Korea (South) HYUNSEUNG LEE
- The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
- Nara Medical University , Japan AYA YAMADA
- , Japan YOSHIKI ISHII
- University of Yamanashi , Japan HIROAKI WATANABE
- Inje University Pusan Paik Hospital , Korea (South) JIYEON HAN
- Japanese Red Cross Otsu Hospital , Japan JUN YOSHIDA
- Oita university , Japan NORITAKA KAMEI
- Other , Korea (South) KUNIL KIM
- The Catholic University of Korea Yoeuido St. Mary , Korea (South) OHMIN KWON
- , Japan KEISUKE OSHIMA
- University Clinical Centre in Gdansk , Poland LUKASZ BUDYNKO
- Osaka Metropolitan University Hospital , Japan SHU MATSUSHITA
- , Japan SHUNJIRO NOGUCHI
- Etlik City Hospital, Ankara , Turkey MERIC TUZUN
- Jichi Medical University, School of Medicine , Japan MITSURU MATSUKI
- University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
- Shiga General Hospital , Japan YUSAKU MORIBATA
- GOP Avrasya Hospital/ISTANBUL , Turkey MURAT ULUSOY
- Aichi Medical University , Japan HIROAKI OKADA
- Seoul Medical Center , Korea (South) YONGJOO LEE
- GHICL , France MANUEL TOLEDANO
- Dokkyo Medical University , Japan HIROAKI ARAKAWA
- Seoul Medical Center , Korea (South) HANSEUL CHO
- Chonnam National University Hwasun Hospital , Korea (South) JIWOO JEONG
- , Korea (South) SUNGHYUN JUNG
- Korea University Anam Hospital , Korea (South) KYU-CHONG LEE
- , Japan MATSUNO MAI
- Paras hospital, Panchkula , India SHALEEN RANA
- Kyoto University , Japan SHO KOYASU
- Kobe Children , Japan SHUHEI NORIMOTO
- Kyung Hee University Medical Hospital , Korea (South) JEONG TAEK YOON
- Yonsei University,Severance Hospital , Korea (South) SEO BUM CHO
- Fukuoka university , Japan KEISUKE SATO
- Kantou Rousai Hospital , Japan KAORU SUMIDA
- Ichinomiya Nishi Hospital , Japan Takao Kiguchi
- Matsunami General Hospital , Japan TARO TAKEDA
- Ehime University , Japan TOMOHISA OKADA
- Ehime University , Japan KOTARO MATSUMOTO
- Sotiria Hospital, Athens , Greece VASILIOS TZILAS
- , Japan YUMI MAEHARA
- The Catholic University of Korea Yoeuido St. Mary , Korea (South) CHAWOONG JEON
- University of Yamanashi , Japan KOJIRO ONOHARA
- Chonnam National University Hospital , Korea (South) JAEBONG YANG
- , Japan YUJI OHIZUMI
- , Japan YUKIHISA TAKAYAMA

▶ Correct Answer as Differential Diagnosis : 1/83, 1.2%

- Oita University, Faculty of Medicine , Japan FUMITO OKADA

대한흉부영상의학회 Korean Society of Thoracic Radiology

Archive of Old Cases

Case No : 1477 Date 2026-02-09

Discussion

No. of Applicants : 83