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Pulmonary Arteriovenous Fistulas Developed After Chemotherapy of Metastatic Choriocarcinoma

Seung Hong Choi1, Jin Mo Goo, Hyo-Cheol Kim and Jung-Gi Im

1 All authors: Department of Radiology, Seoul National University College of Medicine, the Institute of Radiation Medicine, SNUMRC, and Clinical Research Institute, 28 Yongon-dong, Chongno-Gu, Seoul 110-744, Korea.



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  		Fig. 1A. —30-year-old woman with choriocarcinoma and multiple pulmonary metastases. Unenhanced chest CT scans obtained at admission show multiple variable-sized nodules (arrows) through both lungs, indicating pulmonary metastases of choriocarcinoma.

 


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  		Fig. 1B. —30-year-old woman with choriocarcinoma and multiple pulmonary metastases. Unenhanced chest CT scans obtained at admission show multiple variable-sized nodules (arrows) through both lungs, indicating pulmonary metastases of choriocarcinoma.

 


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  		Fig. 1C. —30-year-old woman with choriocarcinoma and multiple pulmonary metastases. Unenhanced chest CT scans obtained after eight courses of methotrexate and leucovorin therapy for 2 years show two nodules (arrows) in left lung. These residual nodules communicate with curvilinear structures (arrowheads), suggesting arteriovenous fistulas.

 


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  		Fig. 1D. —30-year-old woman with choriocarcinoma and multiple pulmonary metastases. Unenhanced chest CT scans obtained after eight courses of methotrexate and leucovorin therapy for 2 years show two nodules (arrows) in left lung. These residual nodules communicate with curvilinear structures (arrowheads), suggesting arteriovenous fistulas.

 


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  		Fig. 1E. —30-year-old woman with choriocarcinoma and multiple pulmonary metastases. Unenhanced transverse thin-slab maximum-intensity-projection MDCT scan with lung window setting shows two nodules (arrows) associated with arteriovenous fistulas (arrowheads) in left upper lobe.

 


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  		Fig. 1F. —30-year-old woman with choriocarcinoma and multiple pulmonary metastases. Curved reformatted MDCT image shows nodule (black arrow) associated with arteriovenous fistula in lingular segment of left upper lobe. Note pulmonary artery (arrowheads) and pulmonary vein (white arrows).

 


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  		Fig. 1G. —30-year-old woman with choriocarcinoma and multiple pulmonary metastases. Volume-rendered MDCT image shows nodule (large arrow) associated with arteriovenous fistula in lingular segment of left upper lobe. Note pulmonary artery (arrowheads) and pulmonary vein (small arrows).

 

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