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Ventilation-Perfusion Mismatch Due to Obstruction of Pulmonary Vein

The Mount Sinai Hospital and Medical School of the City University of New York, New York, New York

Correspondence: For reprints contact: David S. Mendelson, MD, Dept. of Radiology, Mount Sinai Hospital, One Gustave L. Levy Place, New York, NY 10029.

ABSTRACT

A lobar perfusion defect in the presence of a normal arterial phase in the pulmonary angiogram may be due to stasis secondary to compression of a pulmonary vein by a hilar or perihilar mass. In this report we present a patient with metastasis to the right lung and hilum by malignant melanoma. A lobar perfusion defect was present in an area of lung that appeared normal by radiograph. This defect was shown to be due to stagnating blood flow reflected by delayed intense capillary phase in that lobe and late opacification of the corresponding draining vein.