Pulmonary Arteriovenous Malformations Mimicking Solitary Pulmonary Nodule with No Symptoms: A Case Report

Pulmonary arteriovenous malformations (PAVMs) consist of abnormal communications between pulmonary arteries and veins that cause pulmonary blood flow diversion. This splits the blood flow through the abnormal anastomosis, not through the alveolar capillaries, leading to gas exchange. PAVMs are mostly located at both sides of the lower lobes, and range from single to multiple occurrences. Most patients have symptoms indicative of PAVMs, or underlying hereditary hemorrhagic telangectasia (HHT). We reported a patient with an abnormal CXR showing a solitary pulmonary nodule (SPN) with no symptoms that was diagnosed as PAVM using video-assisted thoracoscopic (VATS) surgical wedge resection. In this case, we learned that a SPN could be a PAVM, and prior to the advent of good imaging studies, CT-guided fine-needle biopsy for pulmonary lesions was not totally safe and could cause lethal complications. (Thorac Med 2012; 27: 88-93)