Pulmonary Arteriovenous Malformations and Hepatic Involvement in a Patient With Osler-Rendu-Weber Disease

A 55-year-old woman presented to the emergency department with a 3-week history of progressive fatigue and dyspnea and recurrent hemoptysis. A contrast-enhanced computed tomographic (CT) image of her chest showed multiple arteriovenous malformations (AVMs), with the largest in the posterior left upper lobe (Figs 1A, 1B; * pulmonary AVMs; FA feeding artery; DV drainage vein; AO aorta; PT pulmonary trunk). In the CT scan of the patient’s liver, axial early arterial phase image showed abnormal perfusion as a result of the AVM (Fig 2A; AO aorta; IVC inferior vena cava; the AVM in the falciform ligament between the braces; arrows show the focal telangiectasis). A maximum-intensity-projection reconstructed sagittal image showed a small telangiectasis and the early opacification of left hepatic vein caused by the presence of intraparenFig 1.