A lung cyst harbouring a congenital pulmonary varix.

A non-smoker man in his second decade presented to a medical centre with intermittent haemoptysis over 2 years. The haemoptysis was infrequent initially to be ignored, but later, the episodes increased in amount and frequency. Routine blood tests including coagulation profile showed normal results. The chest radiography and echocardiography were normal. The contrast-enhanced CT scan of the chest showed a cystic lesion with intracystic abnormality and surrounding ground-glass opacity in the left upper lobe. The CT pulmonary angiography and invasive pulmonary angiography showed the abnormality to be a dilated pulmonary vessel draining into the left atrium, thereby confirming the diagnosis of congenital pulmonary varix contained within a lung cyst. The patient underwent a successful lobectomy following which he experienced no further haemoptysis.

A Diagnostic Conundrum: Progressive Tubular Lung Mass in Asymptomatic Young Woman.

CASE PRESENTATION: A 39-year-old female avid marathon runner presented with an abnormal chest radiograph obtained during preoperative evaluation prior to bilateral knee replacement because of osteoarthritis. As shown in Figure 1, chest radiograph revealed a focal nodular opacity in the middle lobe. She did not have any prior imaging for comparison.

Extra-abdominal umbilical vein varix in a newborn.

Umbilical vein varices are rare fetal anomalies typically found intra-abdominally and identified on ultrasound prior to birth. Intra-abdominal umbilical vein varices account for approximately 4% of umbilical cord abnormalities and are thought to be a developmental abnormality rather than a congenital malformation. The umbilical vein varix anomaly been shown to be associated with a higher incidence of adverse perinatal outcomes and there is evidence of a relationship between this and chromosomal abnormalities. There have been few case reports of extra-abdominal varices. This case reviews a multiparous Hispanic female who delivered a baby with an extra-abdominal umbilical vein varix who was admitted to the neonatal intensive care unit but had an uncomplicated hospital course. The report reviews strategies for antenatal testing and surveillance of identified varices.

A complex pulmonary vein varix -- diagnosis with ECG gated MDCT, MRI and invasive pulmonary angiography.

A case of an asymptomatic 32-year-old male with a complex congenital pulmonary vein varix is reported herein. Chest X-ray incidentally revealed a tubular opacity passing from the periphery of the left lingula to the mediastinum. ECG gated multidetector computed tomography showed the opacity to be a vessel emptying into the left atrium via the left superior pulmonary vein. In addition, a second vascular structure was noted within the posterior mediastinum that was emptying into the same pulmonary vein. These findings were also confirmed by magnetic resonance imaging, 4D magnetic resonance angiography and invasive arterial angiography. Based on multimodality imaging findings the diagnosis of complex congenital pulmonary venous varix with posterior mediastinal extension was established.

Isolated fetal intra-abdominal umbilical vein varix: clinical importance and recommendations.

This series describes a single center's experience in follow-up and management of fetuses with an isolated fetal intra-abdominal umbilical vein varix. All cases with a fetal intra-abdominal umbilical vein varix that were diagnosed or referred to our medical center over 15 years were followed and managed. The definition of a fetal intra-abdominal umbilical vein varix used was a segment dilated to 9 mm or greater or at least 50% wider than the diameter of the adjacent umbilical vein. Over the 15-year period, our center had approximately 65,000 births with 28 cases of isolated fetal intra-abdominal umbilical vein varices: a prevalence rate of 1 case per 2300 births. Three of the 28 cases (10.7%) had intrauterine growth restriction. Five of 30 fetuses (17%) showed turbulent flow in the varix. We had no cases of intrauterine fetal death, and 27 of the 28 neonates had good outcomes. In contrary to earlier reports, we found that when a fetal intra-abdominal umbilical vein varix is isolated, a good fetal outcome is expected. On the basis of our experience, we have changed our policy and do not recommend inducing preterm labor. Nevertheless, close fetal surveillance until delivery is warranted.

[Variants of anatomical structure of lower-limb veins as a possible cause of the development of primary varicosity].

In order to reveal anatomical prerequisites for the development of primary varicose veins we investigated the structure of the venous system on a total of 53 adult human cadaveric lower extremities. Congenital morphological grounds providing the phlebohaemodynemics of the lower limbs are ambiguous in different individual forms. We revealed a total of 18 variants of the structure of deep veins, reflecting various stages of the embryonic development. In 34.1% of cases we saw the forms characteristic of incomplete reduction and unfinished transformation, with 30.2% of cases showing the utmost degree of reduction and transformation. An inadequate outflow along the deep veins conditioned by their anatomical structure is a prerequisite for the development of valvular insufficiency and venous reflux to the superficial veins followed by varicose transformation thereof

[Diagnosis and treatment of varicose veins. Part 1: definition, epidemiology, etiology, classification, clinical aspects, diagnostic and indications]. / Diagnose und Therapie der primären Varikose. Teil 1: Definition, Epidemiologie, Ätiologie, Klassifikation, Klinik, Diagnostik und Indikationsstellung.

This is the first of two articles on the diagnosis and treatment of varicose veins. Primary varicosis is a congenital degenerative disease of the peripheral venous system of the lower extremities. The realisation factors are age, female sex and pregnancy. Degeneration of the peripheral veins leads to dilatation of the lumen and insufficient closure of the valves resulting in a backflow of blood from deep to the superficial venous system. This leads to ambulatory hypertension in the superficial venous system and recirculation of noteworthy amounts of venous drainage blood in the affected leg. Without treatment this results in the long term in variable degrees of decompensation of the recirculation pathways and an increasing (volume-induced) secondary insufficiency of the deep venous system. The result corresponds to the clinical symptoms of chronic venous insufficiency (CVI). When treatment is started early enough the pathological course can be reduced or avoided. The various therapeutic measures will be described in the second article of this series.

[Percutaneous sclerotherapy for the treatment of soft-tissue venous malformations: a retrospective study of 68 patients]. / Sclérose percutanée des malformations veineuses superficielles: étude rétrospective de 68 cas.

PURPOSE: To evaluate the efficacy of percutaneous sclerotherapy for the treatment of venous malformations (VMs) with regards to cosmetic and functional outcome as a function of their size and to review the complications. MATERIALS AND METHODS: A retrospective study was performed between January 1997 and January 2002 on 68 patients (45 females and 23 males) ranging in age from 3 to 60 Years at the CHRU of Tours. RESULTS: Percutaneous sclerotherapy was a very effective treatment for small and medium-size VMs, for which the aim was to achieve cure. Aetoxisclerol and Ethibloc are the sclerosing agents used. They were associated with minimal side effects and no major complication. For larger lesions, the treatment was more complex and combined stronger and also more dangerous agents like absolute ethanol and Histoacryl. The aim was then a decrease of cosmetic and functional problems. CONCLUSION: Percutaneous sclerotherapy with Aetoxisclerol, Ethibloc, absolute ethanol or Histoacryl, either alone or before surgery, is a safe and effective method of managing soft-tIssue venous malformations.

Congenital internal and external jugular venous aneurysms in a child.

A 2-year-old boy presented with varices and a neck mass. Imaging studies revealed internal jugular vein aneurysm. Gradual increasing of the mass, potential thrombus formation and cosmetical considerations were indications for surgery. At surgery aneurysms of both the external and internal jugular veins were found and resected.

Hitherto undescribed venous vacuolar myopathy without mucoid degeneration in the varicose saphenous vein of a child.

Varicose vein abnormalities involving the lesser saphenous vein of a 7-year-old boy are presented. The histopathology of the vein wall revealed a vacuolar degeneration without mucoid deposits of the muscle cells, which has not been described previously in the literature in congenital varices.

Congenital orbital varices causing extreme neonatal proptosis.

PURPOSE: To report a 6-week-old male with extreme proptosis caused by thrombosed orbital varices. METHODS: A 6-week-old male presented with advanced proptosis of his left eye. Computed tomography and magnetic resonance imaging studies of the orbits revealed a heterogeneous cystic mass that filled the entire left orbit. Extreme proptosis and corneal exposure prompted urgent surgical excision of the mass. Histopathologic review of the lesion was consistent with orbital varices. CONCLUSIONS: Although orbital varices usually are found in adults, they should be considered in the differential diagnosis of orbital lesions in children. Observation is usually warranted, but surgical intervention may be necessary in advanced cases.

Bockenheimer's syndrome.

A case of a very extensive form of the rare Bockenheimer's syndrome (genuine diffuse phlebectasia) in a 45-year-old female patient is presented. The subject presented phlebectasias of the upper right leg, the vulva and the right side of the abdomen. The diagnostic and therapeutic possibilities for cases of patients with Bockenheimer's syndrome are described.

Intrafibular varix: MR diagnosis.

We describe a case of a surgically proven intraosseous venous anomaly of the fibula in a patient who presented with ankle pain and swelling with deep venous thrombosis. MRI, including gadolinium-enhanced MR angiography, provides a less invasive means than conventional venography for diagnosing these lesions and assessing venous patency while also allowing for evaluation of extravascular structures.