A huge pulmonary arteriovenous malformation (PAVM) presenting with a classical triad of cyanosis, polycythemia and clubbing of the fingers in a 12-year-old boy was confirmed on spiral computed tomography (CT) angiography. Considering the lesion size, central location and its large feeding and drainage vessels, the patient underwent right lower lobe lobectomy without complications.Fig. 1Fig. 2
CT angiogram of the chest shows large encysted vascular lesion communicating with rt. pulmonary artery: (A) transverse section at the level of pulmonary artery shows a large feeding vessel* (1.6 cm); (B) transverse section at the level of lt. atrium, receiving a large drainage vein** measuring 1.8 cm in diameter; (C) 3D sections through the chest show dimensions of the lesion occupying rt. side of chest (10.1 cm × 6.5 cm × 5.8 cm).
CT angiogram of the chest shows large encysted vascular lesion communicating with rt. pulmonary artery: (A) transverse section at the level of pulmonary artery shows a large feeding vessel* (1.6 cm); (B) transverse section at the level of lt. atrium, receiving a large drainage vein** measuring 1.8 cm in diameter; (C) 3D sections through the chest show dimensions of the lesion occupying rt. side of chest (10.1 cm × 6.5 cm × 5.8 cm).
(A) The resected lesion and the affected lobe of the right lung, following open lobectomy. Part (B) shows the preoperative clinical signs; note marked cyanosis of lips, tongue and body and clubbing of fingers (arterial oxygenation 53% at room air). Part (C) shows marked postoperative improvement in cyanosis on 6th postoperative day.
(A) The resected lesion and the affected lobe of the right lung, following open lobectomy. Part (B) shows the preoperative clinical signs; note marked cyanosis of lips, tongue and body and clubbing of fingers (arterial oxygenation 53% at room air). Part (C) shows marked postoperative improvement in cyanosis on 6th postoperative day.
