Answer of December 2005


Clinical History:

A 55-year-old lady presented with stroke.






Pulmonary Arteriovenous Malformation


CT scan of thorax and pulmonary angiogram revealed multiple pulmonary arteriovenous malformations. Hepatic angiogram showed that the hepatic arteries were hypertrophied with increased tortuosity. Fast AV transit was noted diffusely in the whole liver. Features were suggestive of numerous AV shunts at microscopic level in liver parenchyma. A lobular aneurysm was noted in bifurcation of splenic artery. The diagnosis is Hereditary Hemorrhagic Telangiectasia. (HHT or Osler-Weber-Rendu syndrome).