Mediastinal mass or vascular anomaly? Azygos arch dilatation diagnosed with CT venography.

INTRODUCTION

The azygos vein arises below the diaphragm from the ascending lumbar and right subcostal veins, playing a critical role in venous drainage and being susceptible to anomalies.

CASE PRESENTATION: A 40-year-old woman, admitted after trauma, had an incidental finding of an enlarged azygos arch on CT, confirmed by CT angiography and managed conservatively.

DISCUSSION: The embryologic development and complex imaging features of the azygos system may mimic mediastinal masses; advanced CT techniques enable accurate differentiation.

CONCLUSION

Advanced imaging prevented unnecessary invasive procedures and underscored the importance of a timely, systematic diagnostic approach.