Azygos Continuation of the Inferior Vena Cava: Potential for Misdiagnosis as Lung Neoplasm
  • Sharjeel Shaikh
    Wexford General Hospital, Wexford, Ireland
  • Hind Awad
    Wexford General Hospital, Wexford, Ireland
  • Anna Kelly
    Wexford General Hospital, Wexford, Ireland
  • Tadhg Gleeson

Keywords

Azygos continuation, inferior vena cava, lung neoplasm, pneumonia

Abstract

Background: The azygos venous system is an accessory venous pathway supplying an important collateral circulation between the superior and inferior vena cava (IVC). 
Case summary: We report a case of complicated community-acquired pneumonia with interruption of the IVC with azygos continuation that was misdiagnosed as lung neoplasm. 
Discussion: The aim of this case report is to emphasize the importance of recognizing an enlarged azygos vein at the confluence with the superior vena cava and in the retrocrural space to avoid misdiagnosis as a right-sided para-tracheal mass. The angiographic features and clinical importance of this condition are discussed.

VIEW THE ENTIRE ARTICLE

References

  • Dudiak CM, Olson MC, Posniak HV. CT evaluation of congenital and acquired abnormalities of the azygos system. Radiographics 1991;11:233–246.
  • Fleischner FG, Udis SW. Dilatation of the azygos vein: a roentgen sign of venous engorgement. Am J Roentgenol 1952;67:569–575.
  • Gray H, William PL, Warwick R, editors. Gray’s anatomy of the human body. 36th ed. Philadelphia: Saunders; 1980, p. 622–800.
  • Sahin H, Pekcevik Y, Aslaner R. Double inferior vena cava (IVC) with intrahepatic interruption, hemiazygos vein continuation, and intrahepatic venous shunt. Vasc Endovascular Surg 2017;51:38–42.
  • Koc Z, Oguzkurt L. Interruption or congenital stenosis of the inferior vena cava: prevalence, imaging, and clinical findings. Eur J Radiol 2007;62:257–266.
  • Bass JE, Redwin MD, Kramer LA, Huynh PT, Harris Jr JH. Spectrum of congenital anomalies of the inferior vena cava: cross-sectional imaging findings. Radiographics 2000;20:639–652.
  • Piciucchi S, Barone D, Sanna S, Dubini A, Goodman LR, Oboldi D, et al. The azygos vein pathway: an overview from anatomical variations to pathological changes. Insights Imaging 2014;5(5):619–628.
  • Sheley RC, Nyberg DA, Kapur R. Azygous continuation of the interrupted inferior vena cava: a clue to prenatal diagnosis of the cardiosplenic syndromes. J Ultrasound Med 1995;14:381–387.
  • Koc Z, Oguzkurt L. Interruption or congenital stenosis of the inferior vena cava: prevalence, imaging, and clinical findings. Eur J Radiol 2007;62:257–266.
  • Mihmanli I, Bulakbasi N, Kantarci F, Adaletli I, Pabuscu Y. The value of ultrasonography in interrupted inferior vena cava with azygos continuation. Eur J Ultrasound 2001;14:179–182.
  • Chait A. Interstitial pulmonary edema. Circulation 1973;45:1223–1330.
  • Marano P. La radiografia funzionale del torace. Verona: Cortina; 1986.
  • Chevallier P, Peten EP, Marcy PY, Fabiani P, Diaine B, Padovani B. Inferior vena cava hypoplasia with intrahepatic venous continuation: sonographic, angiographic and MR features including MR angiography. Clin Imaging 1999;23:99–102.
  • Liu Y, Guo D, Li J, Zhang X, He J, Huang M, et al. Radiological features of azygos and hemiazygos continuation of inferior vena cava: a case report. Medicine (Baltimore) 2018;97(17):e0546.
  • Views: 534
    HTML downloads: 410
    PDF downloads: 271


    Published: 2021-03-09
    Issue: 2021: Vol 8 No 3 (view)


    How to cite:
    1.
    Shaikh S, Awad H, Kelly A, Gleeson T. Azygos Continuation of the Inferior Vena Cava: Potential for Misdiagnosis as Lung Neoplasm. EJCRIM 2021;8 doi:10.12890/2021_002385.