Chest
Volume 59, Issue 1, January 1971, Pages 101-103
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Anomalous Single Left Pulmonary Vein Mimicking A Parenchymal Nodule

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A patient with the preoperative diagnosis of indeterminate pulmonary nodule which proved at operation to be a single left pulmonary vein has been presented. No resection was performed and delayed postoperative pulmonary angiography confirmed the operative diagnosis. We discuss differential diagnosis and a retrospective analysis of how unnecessary thoracotomy might have been avoided.

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CASE REPORT

A 67-year-old Caucasian woman was admitted to Harbor General Hospital complaining of mild left lower chest pain associated with a nonproductive cough. Medical attention had previously not been obtained, but was sought on admission because of recent intensification of symptoms. Hemoptysis, night sweats, fever, dyspnea or exposure to tuberculosis were denied. This non-smoker had involuntarily lost ten pounds in the two-month period prior to hospital admission.

Past history was non-contributory. No

COMMENT

Accurate diagnosis could have spared this patient thoracotomy. Despite careful review of the film preoperatively, the pulmonary venous anomaly was not suspected. Postoperatively, the roentgenograms were presented as an unknown to a consulting radiologist and still the diagnosis was not obvious. Retrospectively, however, the cause of the radiologic density can be suspected on the basis of the location of the lesion. In view of the almost absent pulsations of the large veins of the lungs,

ACKNOWLEDGMENT

The authors thank Leo G. Rigler, M.D. for reviewing this manuscript and serving as consultant re radiology.

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