Korean J Radiol.  2009 Feb;10(1):89-92. 10.3348/kjr.2009.10.1.89.

Adventitial Cystic Disease of the Femoral Vein: a Case Report with the CT Venography

• Seo JY
• Chung DJ
• Kim JH

• KMID: 1088684
• DOI: http://doi.org/10.3348/kjr.2009.10.1.89

Abstract

Fewer than 20 cases of adventitial cystic disease of the vein have been reported in the worldwide literature. This small number of reported cases may be due not only to the disease's low incidence, but also to the difficulty in making the proper diagnosis. Many techniques have been used to investigate this disease, but venography has been the traditional diagnostic tool. In this report we present a case of adventitial cystic disease that was well demonstrated by CT venography.

Keyword

Veins, iliac; Veins, stenosis or obstruction; Computed tomography (CT), angiography

MeSH Terms

Aged
Cysts/pathology/*radiography
Femoral Vein/pathology/*radiography
Humans
Male
Peripheral Vascular Diseases/pathology/*radiography
*Tomography, X-Ray Computed

Figure

• 

  Fig. 1 US of adventitial cystic disease in 69-year-old man. A. US showed relationship between cystic mass and left common femoral vein. Cystic mass (*) that contained hypoechoic materials is attached to medial side of left common femoral vein (v). B. Venous phase axial CT scan shows approximately 1.7 cm sized round, nonenhancing cystic mass (long arrow) compressing left common femoral vein with dilated medial circumflex femoral and obturator veins, which provide collateral circulation. C. Coronal reconstruction image shows low attenuation nonenhancing mass (white arrow) in left common femoral vein. D. Posterior view of three dimensional volume rendering image of left common femoral vein showing near complete obstruction of left common femoral vein (white arrow) with formation of multiple collateral vessels. E. Photomicrograph of excised left common femoral vein. ×40; Elastin Van Gieson stain reveals widening of adventitial layer of vein and replacement of elastic tissue by fibrous connective tissue (arrow), which is all consistent with cystic adventitial disease. Cyst was removed (asterisk). F. Photomicrograph of excised left common femoral vein. ×40; Hematoxylin & Eosin stain shows adventitial hemorrhage and fibrin deposition within widened adventitial layer of vein (arrow). * = cyst G. Postoperative CT venography of patient's adventitial cystic disease. Lateral view of three dimensional volume rendering image showing that left common femoral vein (arrow) runs through previous cystic mass site and multiple collateral vessels have disappeared.

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