An unusual opacity of the right base

The scimitar syndrome or pulmonary venolobar syndrome is a rare, complex an d variable malformation of the right lung characterized by an abnormal righ t sided pulmonary venous drainage in the inferior vena cava, malformation o f the right lung, abnormal arterial supply and sometimes cardiac malformati ons. We present a case in which this diagnosis was suspected on an abnormal rout ine chest radiograph in a 38-year-old asymptomatic woman. Most patients are asymptomatic; symptomatic patients have a marked left-to-right shunt or a severe congenital heart disease. They usually suffer from shortness of brea th, asthenia or repeated chest infections. Usually, the posteroanterior che st radiograph can confirm the diagnostic. It shows the abnormal vein draini ng int the inferior vena cava as a curved vascular shadow with a scomitar l ike appearance. However, in some cases, when the scimitar vein is masked by the overlaying cardiac shadow, computed tomography, angiography and magnet ic resonance imaging can be helpful by showing the abnormal vein and its in sertion into the inferior vena cava. Scimitar syndrome seldom necessitates surgical intervention. However, repeated lung infections can sometimes requ ire lobectomy or pneumonectomy, left-to-right shunt vascular surgery to red irect the scimitar vein into the left atrium.