Incidental Finding of Pulmonary Azygos Lobe and Imaging Findings: A Case Report

A 42-year-old male presented with dyspnoea post-surgery for a benign brain tumour and was referred to the radiology department for pulmonary CT angiography on account of suspected pulmonary embolism.

The CT pulmonary angiogram showed filling defects in the RT and LT main pulmonary arteries, their segmental and subsegmental arteries confirming pulmonary embolism. Incidentally visualized is a horizontally uprooted azygos vein making a profound pleural gap into the apical fragment of the correct upper flap making an Azygos projection. An Azygos projection is a typical anatomic variation of the correct upper projection because of invagination of the azygos vein and pleura during embryological advancement in the hatchling. It's anything but a genuine extra projection as it doesn't have its possess bronchus. Azygos lobe can mimic various conditions such as bulla or abscess, pulmonary nodule and lung mass. Hence, radiologists, thoracic surgeons, and respiratory care physicians should be aware of this anatomical variant and the clinical implications of azygos lobe as this can compromise the success of thoracoscopic procedures for sympathectomy or thoracic surgery.

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