Published in:
01-02-2016 | Clinical Practice: Clinical Images
Scimitar Syndrome
Published in: Journal of General Internal Medicine | Issue 2/2016
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A 38-year-old woman presented with dyspnea and fatigue for 1 week. Physical examination was unremarkable. Laboratory tests were unrevealing. Chest X-ray showed dextrocardia and a right lung mass measuring 5 × 4 cm (Fig. 1). Computed tomography (CT) of the chest revealed an accessory lobe of the liver extending into the chest cavity through a defect in the posterior right hemi-diaphragm, and the right pulmonary vein draining into the infradiaphragmatic inferior vena cava (IVC) instead of the left atrium (Fig. 2), consistent with Scimitar syndrome.
Figure 1
Chest x-ray showing the scimitar sign (arrows), dextrocardia, hypoplastic right lung and well-circumscribed mass at the right lower lung base (star).
Figure 2
Panel a Chest CT scan with contrast in coronal section demonstrates the scimitar vein (SV), a large anomalous right pulmonary vein coursing into the infradiaphragmatic inferior vena cava (IVC). An accessory liver lobe is noted at the base of right hemithorax (star). Panel b 3 D volume rendered CT scan image shows the scimitar vein draining into the inferior vena cava. Panel c Posterior view of heart with scimitar vain (SV) draining below the diaphragm. IVC; inferior vena cava, SVC; superior vena cava, SV; scimitar vein, RPA; right pulmonary artery, Ao; aorta.
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