Clinical Presentation

The patient is a 39-year-old man.

(A) Frontal chest radiograph shows curvilinear structure (arrow) in the right lower lung field, parallel to the right side of the heart, associated with tenting of the right hemidiaphragm. There is dextroposition of the heart. (B) Infused computed tomographic (CT) scan shows a curvilinear structure extending from the pulmonar y vein to the posterior pleura (arrow). (C,D) Infused CT scan shows a structure crossing the diaphragm posteriorly, coursing behind the diaphragm medially, and draining into the renal vein (arrows).

Differential Diagnosis