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Nonbronchial Collateral Supply from the Hepatic Arteries of a Patient with Hemoptysis

Ho Jong Chun1, Seung-Schik Yoo2, Hak Hee Kim1, Jae Young Byun1 and Byung Gil Choi1

1 Department of Radiology, College of Medicine, The Catholic University of Korea, 505 Banpo-Dong, Seocho-Ku, Seoul 137-040, Korea.
2 Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115.



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  		Fig. 1A. —39-year-old man with organizing pneumonia in lower lobe of right lung. Contrast-enhanced CT scan of chest shows consolidation with multiple air bronchograms. Subtle amount of pleural effusion (arrows) can be observed.

 


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  		Fig. 1B. —39-year-old man with organizing pneumonia in lower lobe of right lung. Selective arteriogram shows that right seventh intercostal artery (arrows) is hypertrophied and reveals hypervascular stain and arteriovenous shunt in base of right lower lobe.

 


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  		Fig. 1C. —39-year-old man with organizing pneumonia in lower lobe of right lung. Right renal arteriogram shows hypertrophied inferior phrenic artery (arrows) arising from right renal artery. Hypervascular stain and arteriovenous shunt are visible in base of right lower lobe.

 


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  		Fig. 1D. —39-year-old man with organizing pneumonia in lower lobe of right lung. Right subclavian arteriogram reveals that right internal mammary artery (arrows) is also hypertrophied and depicts associated hypervascular stain and arteriovenous shunt involving base of right lower lobe.

 


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  		Fig. 1E. —39-year-old man with organizing pneumonia in lower lobe of right lung. Thoracic aortogram obtained after embolization of right lateral thoracic and thoracodorsal arteries during third session of transarterial embolization (23 days after initial embolization) shows focal hypervascular lesion (arrows) involving base of right lower lobe. Image was obtained during late arterial phase using anteroposterior projection and injection of 40 mL of contrast medium at rate of 20 mL/sec.

 


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  		Fig. 1F. —39-year-old man with organizing pneumonia in lower lobe of right lung. Selective hepatic arteriogram shows that hypervascular lesion (arrows) of right lower lobe is mainly supplied by nonbronchial systemic collaterals originating from hepatic arteries.

 

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