Diagnosis of a left lower pulmonary vein thrombus by 64-MDCT.

Pulmonary vein thrombosis is undiagnosed and thought to be rare. Stroke is a serious clinical problem and atrial fibrillation is associated with it. As a cardiac thrombus, a thrombus in the left atrial appendage and the left atrium are well known, but a pulmonary vein thrombus is not thought to be a common cause of stroke. A 69-year-old woman with transient ischaemic stroke had chest pain and was examined by 64-slice multidetector CT (64-MDCT). 64-MDCT illustrated no coronary artery stenosis but a thrombus in the left lower pulmonary vein (LLPV), which was in contact with the lower surface of the LLPV. The pulmonary vein cells in contact with the thrombus lack oxygen and nutrients, which may control physiological processes, such as development, differentiation and pathological responses in the pulmonary vein. These effects are unknown and more studies are desirable. 64-MDCT can demonstrate a thrombus in the pulmonary vein and hence a pulmonary vein thrombus is not rare.