Question:

Which statements are true regarding the empty azygos fissure:
1. It can develop when there is an azygos fissure in a patient with a pneumothorax.
2. Develops more frequently in patients who smoke.
3. It is typically seen on chest radiography as a supernumerary line in projection of the right lung apex, in a paramediastinal position, with a teardrop-shaped opacity in its lower part.
4. The empty azygos fissure is a term describing the disappearance of the azygos fissure after pulmonary reexpansion following atelectasis.
5. Describes an image of azygos vein thrombosis within an azygos fissure.





Answer:

The correct answer for the question "Which statements are true regarding the empty azygos fissure:" is:

1. It can develop when there is an azygos fissure in a patient with a pneumothorax.



Explanation
1. [It has been described in the literature various etiologies for the migration of the azygos vein: increased intrathoracic pressure, spontaneous or iatrogenic pneumothorax.]

2. The development of a empty azygos fissure is not related to a smoking history. [This particular anatomical condition associated with collapse of the right upper lung lobe, may allow the displacement of the azygos vein outside the azygos fissure.]

3. It can be seen on chest radiograph as a supernumerary line in projection of the right lung apex, in a paramediastinal position, but there is no image of the vein in its lower part (teardrop-shaped opacity). [In these situations, identification of the azygos vein in its usual position at the bottom of the fissure, visible as a teardrop-shaped opacity, confirms the correct diagnosis of azygos lobe. However this classical sign may be absent in case of empty azygos fissure.]

4. The empty azygos fissure is a term describing the visualization of the azygos fissure in addition to an azygos vein in a close paramediastinal position. The disappearance of the azygos fissure after pulmonary reexpansion following an atelectasis is described as a vanishing azygos lobe. [Less frequently, complete disappearance of the fissure has been described (named "vanishing azygos lobe"), after reexpansion and obliteration of the right upper lung.]

5. Does not describe an image of an azygos vein thrombosis in an azygos accessory fissure. [The empty azygos fissure is the consequence of the displacement of the azygos vein out of the fissure with a close paramediastinal position, related to lung collapse during pneumothorax or large drained effusion.]



From the manuscript:
The Empty Azygos Fissure
Radiology Case. 2013 Apr; 7(4):10-15


This article belongs to the Chest section.




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From the manuscript

The Empty Azygos Fissure

Free full text article: The Empty Azygos Fissure

Abstract
The azygos fissure is typically visible on chest radiography as a right para-mediastinal supernumerary line in projection of the right lung apex. The azygos vein, located at the bottom of the fissure, is visible as a teardrop-shaped opacity. The empty azygos fissure is a rare finding. It is the consequence of the displacement of the azygos vein out of the fissure with a close paramediastinal position. This phenomenon, related to lung collapse, has been described in the literature as the migration of the azygos vein due to various etiologies such as increased intrathoracic pressure, spontaneous or iatrogenic pneumothorax, or even during sudden development of kyphosis. In our clinical case, the empty azygos fissure was developed after drainage of a large right pleural effusion. An empty azygos fissure must therefore suggest a history of pulmonary atelectasis related to pneumothorax or large drained effusion.






References



1. Drakonaki EE, Voloudaki A, Daskalogiannaki M, Karantanas AH, Gourtsoyiannis N. Migratory azygos vein: a case report. J Comput Assist Tomogr 2008, 32(1):99-100
Get full text
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2. Villanueva A, Caceres J, Ferreira M, Broncano J, Pallisa E, Bastarrika G. Migrating azygos vein and vanishing azygos lobe: MDCT findings. AJR Am J Roentgenol 2010, 194(3):599-603
Get full text
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3. Maldjian PD, Phatak T. The empty azygos fissure: sign of an escaped azygos vein. J Thorac Imaging 2008, 23(1):54-56
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


4. Godwin JD, Tarver RD. Accessory fissures of the lung. AJR Am J Roentgenol 1985, 144(1):39-47
Get full text
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5. Asai K, Urabe N, Takeichi H. Spontaneous pneumothorax and a coexistent azygos lobe. Jpn J Thorac Cardiovasc Surg 2005, 53(11):604-606
Get full text
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6. Betschart T, Goerres GW. Azygos lobe without azygos vein as a sign of previous iatrogenic pneumothorax: two case reports. Surg Radiol Anat 2009, 31(7):559-562
Get full text
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7. Caceres J, Mata JM, Andreu J. The azygos lobe: normal variants that may simulate disease. Eur J Radiol 1998, 27(1):15-20
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


8 . Hansell DM, Bankier AA, MacMahon H, McLoud TC, Muller NL, Remy J. Fleischner Society: glossary of terms for thoracic imaging. Radiology 2008, 246(3):697-722
Get full text
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9. Wemmelund KB, Lie RH, Juhl-Olsen P, Frederiksen CA, Hermansen JF, Sloth E. Pleural effusion decreases left ventricular pre-load and causes haemodynamic compromise: an experimental porcine study. Acta Anaesthesiol Scand 2012 Aug;56(7):833-9
Get full text
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10. Armen RN, Morrow CS. The Abnormally Situated Azygos Vein : X-Ray Demonstration of its Distention in Congestive Failure and in Various Positions. Circulation 1956 14: 1079-1083.
Get full text
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