RESUMO
The axillopectoral muscle is a rarely discussed variant of muscular anatomy of the axilla, with various clinical implications. We report a case of a 7-year-old girl with multiple genetic and developmental abnormalities who presented with asymmetrical right axillary bulging of unknown etiology. MRI demonstrated a small accessory axillary muscle, known as Langer's axillary arch and/or the axillopectoral muscle. Other than soft-tissue asymmetry, the patient experienced no additional related symptoms. However, this is an important variant to be aware of, as it can easily be discovered on imaging and may be a causative agent for various upper extremity symptoms that may resolve with appropriate recognition and surgical intervention.
Assuntos
Axila/anormalidades , Músculo Esquelético/anormalidades , Anormalidades Múltiplas , Variação Anatômica , Axila/diagnóstico por imagem , Criança , Feminino , Humanos , Imageamento por Ressonância Magnética , Músculo Esquelético/diagnóstico por imagemRESUMO
BACKGROUND: Coronary to pulmonary artery fistula (CPAF) is rare; reports on the prevalence and types of CPAF in a large cohort of patients are scarce. PURPOSE: To analyze the prevalence and types of CPAF on computed tomography coronary angiography (CTCA) in a large Chinese population. MATERIAL AND METHODS: CTCA data of 58,533 patients from five Chinese tertiary referral medical centers were retrospectively studied. The prevalence, origin, aneurysmal sac, fistula tracts, and extracardiac communication of CPAF were recorded. CTCA findings were compared with conventional coronary angiography when possible. RESULTS: Ninety-nine patients had CPAF (prevalence of 0.17%). Of the 99 CPAF cases, fistulas were found to originate from either both coronary arteries in 52 patients or from one coronary artery (33 cases from the left and 14 cases from the right coronary artery). Ten CPAF patients were complicated with the communication of extracardiac arteries. Fifteen (15.2%) CPAF patients had aneurysmal sac formation. Thirty (30.3%) patients had a single fistula tract, while 69 (69.7%) patients had multiple fistula tracts. CTCA findings in 16 patients were similar to those at DSA. CONCLUSION: Based on this large cohort, the prevalence of CPAF in the Chinese population is about 0.17%, with origin from either the left or right coronary artery or from both. CTCA can clearly visualize the types, abnormal vascular tracts, and aneurysmal sac formation of CPAF.