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Differentiating systemic artery-to-pulmonary artery fistula from pulmonary arteriovenous malformation: A case report

Year: 2025

Type: article

Abstract: This report describes a rare case of a systemic artery-to-pulmonary artery fistula initially misdiagnosed as a pulmonary arteriovenous malformation in a 64-year-old male with severe emphysema. While a suspected pulmonary arteriovenous malformation was identified in the left lung on plain computed tomography, contrast-enhanced imaging revealed an aneurysmal nodule connected to the left inferior phrenic and internal mammary arteries, suggesting a systemic artery-to-pulmonary artery fistula. Selective angiography confirmed the diagnosis. The absence of pulmonary vein dilation on computed tomography is the key to differentiating a systemic artery-to-pulmonary artery fistula from a pulmonary arteriovenous malformation. Additionally, using contrast-enhanced computed tomography with both pulmonary artery and late phases helps prevent misdiagnosis of pulmonary embolism and may raise the suspicion of a systemic artery-to-pulmonary artery fistula.

Source: Radiology Case Reports

DOI: 10.1016/j.radcr.2025.01.064

Authors: Hiroshi Baba, Kazunori Fukasawa, Hiroyuki Kawaguchi, Hiromu Hidaka, Yoshiki Asayama

Institution: Oita University

Language: English

Topic: Vascular Anomalies and Treatments

Subfield: Genetics

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $600