A dilated azygos vein can simulate a mediastinal tumor on chest roentgenograms and requires specific diagnostic differentiation to avoid inappropriate therapies such as irradiation.
Clinicians should differentiate azygos phlebectasia from mediastinal masses to avoid misdirected therapy; leaves open systematic validation of diagnostic criteria.
Case Reports1 January 1954MEDIASTINAL TUMOR SIMULATED BY AZYGOS PHLEBECTASIASAYER WILLIAM J., LOREN F. PARMLEY JR., JOHN DE L. S. MORRISSAYER WILLIAM J.Search for more papers by this author, LOREN F. PARMLEY JR.Search for more papers by this author, JOHN DE L. S. MORRISSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-40-1-175 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe normal azygos vein produces a recognizable radiographic shadow in a variable number of posterior-anterior chest roentgenograms.1 Less frequently the x-ray image of a dilated azygos vein has been mistaken for a mediastinal tumor.2, 3, 4, 5 In fact, on occasion, patients with subsequently proved intrathoracic azygos phlebectasia or other vascular abnormalities have received the "therapeutic trial" of irradiation therapy2, 5, 6, 7 so recently deprecated by Peabody.8This report is concerned with two illustrative case histories, the basic etiology of azygos phlebectasia, and the specific methods of differentiating this entity from a true mediastinal tumor.CASE REPORTSCase 1....Bibliography1. StaufferLa BreeAdams HMJFH: The normally situated arch of the azygos vein; its roentgenologic identification and catheterization, Am. J. Roentgenol. 66: 353, 1951. Google Scholar2. MclntireSykes FTEM: Obstruction of the superior vena cava: review of literature and report of 2 personal cases, Ann. Int. Med. 30: 925, 1949. LinkGoogle Scholar3. Edwards EA: Functional anatomy of the porta-systemic communications, Arch. Int. Med. 88: 137, 1951. CrossrefGoogle Scholar4. Robb GP: Personal communication quoted by Edwards.3 Google Scholar5. Rose LB: Obstruction of the superior vena cava of twenty-five years duration, J. A. M. A. 150: 1198, 1952. CrossrefMedlineGoogle Scholar6. HinshawRutledge HCDI: Lesions in superior mediastinum which interfere with venous circulation, J. Lab. and Clin. Med. 27: 908, 1942. Google Scholar7. AbbottHopkinsLeigh OAWATF: The role of angiocardiography and venography in mediastinal and paramediastinal lesions, J. Thoracic Surg. 18: 869, 1949. CrossrefGoogle Scholar8. Peabody JW: Present trends in diagnosis and therapy of diseases of the chest, J. A. M. A. 150: 1469, 1952. CrossrefMedlineGoogle Scholar9. Carlson HA: Obstruction of the superior vena cava, Arch. Surg. 29: 669, 1934. CrossrefGoogle Scholar10. RobbSteinberg GPI: A practical method of visualization of the chambers of the heart, the pulmonary circulation and the great vessels in man, J. Clin. Investigation 17: 507, 1938. Google Scholar11. JacobsLevyChastantStrauss JJLHH: Angiocardiography in obstruction of the superior vena cava, J. A. M. A. 147: 11, 1951. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: *Received for publication June 19, 1953.From the Medical and Radiology Service, Walter Reed Army Hospital, Washington, D. C. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPseudotumoral paraesophageal varicesDilatation of the azygos vein simulating a mediastinal tumour.Pseudotumoral Mediastinal Mass Associated with Portal HypertensionDilatation of Azygos Vein Simulating Mediastinal TumourErkrankungen und Tumoren des MediastinumsDilated Azygos and Hemiazygos Veins Presenting as Paravertebral Intrathoracic MassesRespiratory SystemDilated Azygos Vein Simulating Mediastinal TumorThe mediastinum in portal hypertensionDilated Azygos Vein Simulating a Mediastinal TumorHerz- und Perikardtumoren 1 January 1954Volume 40, Issue 1Page: 175-182KeywordsDiagnostic radiologyEtiologyMediastinal tumorsThoraxVeins Issue Published: 1 January 1954 PDF downloadLoading ...
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