CTICasesPulmonary Arteriovenous Malformation with Systemic Collateral Supply
[...]. Pulmonary Arteriovenous Malformation with Systemic Collateral Supply. CTICases. Published February 18, 2017. https://str-case-explorer.pages.dev/c/xx96c
Imaging findings
Contrast-enhanced CT reveals a pulmonary arteriovenous malformation (PAVM) in the left upper lobe, fed by a pulmonary artery and draining into a pulmonary vein. Notably, systemic collaterals from both internal mammary arteries descend and penetrate the diaphragmatic surface to directly feed the malformation.
Key takeaways
While pulmonary arteriovenous malformations are typically supplied exclusively by pulmonary arteries, they can rarely recruit systemic arterial supply, particularly from the internal mammary or phrenic arteries. The presence of multiple vascular malformations combined with clinical symptoms like recurrent epistaxis strongly suggests Hereditary Hemorrhagic Telangiectasia (HHT, or Osler-Weber-Rendu syndrome).
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