Purpose or Case Report: Pulmonary vein thrombosis is an exceedingly rare occurrence but should be considered in the differentials in evaluation for opacity seen on the chest radiograph, in a coagulopathic pediatric patient.
Methods & Materials: A 17 year old female with systemic lupus erythematosus presents with cough and congestion. On the initial chest radiograph, right middle lobe and lower lobe opacities were seen concerning for pneumonia. After renal clearance, CT angiogram of the chest was performed to assess for pulmonary embolism.
Results: Large pulmonary embolis involving segmental and subsegmental branches of the right pulmonary artery to the ipsilateral lower lobe as well as segmental subsegmental branches of the draining ipsilateral pulmonary vein. A large pulmonary infarct in the posterior right lower lobe identified. Additional small pulmonary arterial embolus to a subsegmental branch to the anterior segment of the left upper lobe identified.
Conclusions: While extremely rare, pulmonary vein thrombosis should be included in one's search pattern when interpreting CT angiogram of the chest to assess for any pathology including pulmonary embolism.