Pulmonary Arteriovenous Malformation in a 43-Year-Old Male Patient

Pulmonary arteriovenous malformation (PAVM) is an embryonic disorder of pulmonary vessels characterized by a communication between arterial and venous vessels. It occurs in 2–3 cases per 100 thousand population. In 60–70% of cases, PAVM can be single, in 30–40% of cases they are multiple, in 75% of cases – unilateral. It is known that the effect of oncogenes, teratogens, and ionizing radiation in the 7–12th weeks of embryogenesis is a prerequisite for the formation of vascular anomalies. However, the main role belongs to genetic factors involved in angiogenesis, inflammatory cytokine genes and genes encoding factors involved in vascular wall remodeling. The article presents a clinical case of PAVM in S4, S5 of the left lung diagnosed by contrast-enhanced multislice computed tomography. The pathology was detected in a 43-year-old male patient who complained of non-productive cough, inspiratory dyspnea with minor physical exertion, headaches, severe general weakness, which appeared after left-sided pneumonia suffered a month before admission to the hospital. Left-sided video-assisted thoracic surgery was performed with segmentectomy of S4, S5 left lung segments. Histological examination revealed arteriovenous anastomoses.

1. Filinov IV, Petrov EI, Tsygina EN, et al. Radiological assessment of pulmonary arteriovenous malformations in children. Russian Electronic Journal of Radiology. 2013; 3(3): 32–40 (in Russ).

2. Nosher L, Murillo PG, Liszewski M, et al. Vascular anomalies: a pictorial review of nomenclature, diagnosis and treatment. World J Radiol. 2014; 6(9): 677–92. http://doi.org/10.4329/wjr.v6.i9.677.

3. Jha AK, Sunder A. An unusual case of pulmonary arterio-venous fistula (PAVF). J Family Med Prim Care. 2019; 8(10): 3408–11. http://doi.org/10.4103/jfmpc.jfmpc_580_19.

4. Urykov AD. Morphology of brain arteriovenous malformations. Modern Technologies in Medicine. 2011; 3: 116–8 (in Russ).

5. Erkinova SA, Kiselyov VS, Strelnikov NV, et al. Study of the association of polymorphic variants rs1333040 and rs7865618 chromosome 9p21 with the development of arteriovenous malformations. Medical Genetics. 2016; 15(5): 61–4 (in Russ). http://doi.org/10.1234/XXXX-XXXX-2016-5-61-641–64.

6. Kostrova OYu, Mikhailova MN, Semenova OV, et al. Arteriovenous malformations of various localization: own observations and literature review. Acta Medica Eurasica. 2020; 4: 25–32 (in Russ). http://doi.org/10.47026/2413-4864-2020-4-25-32.

7. 2025 ISSVA Classification. Available at: https://www.issva.org/classification (accessed 07.10.2025).

8. Enjolras O, Wassef M, Chapot R. Color atlas of vascular tumors and vascular malformations. Cambridge University Press; 2007: 1–11.

9. Goncharova YaA. Hemangiomas and vascular malformations. Current theories and therapeutic management. Child's Health. 2013; 6: 148–52 (in Russ).

10. Milliken JB, Glowacki J. Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg. 1982; 69(3): 412–22. http://doi.org/10.1097/00006534-198203000-00002.

11. Tsap NA, Vinogradova IA, Nekrasova EG. A rare lung development defect in children – arteriovenous malformation of the lower lobe of the right lung (a case report). Children’s Hospital. 2011; 1: 56–9 (in Russ).

12. Fetisov NI, Maskin SS. Arteriovenous anomalies of lung vessels: pathomorphology, diagnostics, surgical treatment. Grekov's Bulletin of Surgery. 2017; 176(3): 102–7 (in Russ). http://doi.org/10.24884/0042-4625-2017-176-3-102-107.

13. Lacombe P, Lacout A, Marcy PY, et al. Diagnosis and treatment of pulmonary arteriovenous malformations in hereditary hemorrhagic telangiectasia: an overview. Diagn Interv Imaging. 2013; 94(9): 835–48. http://doi.org/10.1016/j.diii.2013.03.014.

14. Schimmel K, Ali MK, Tan SY, et al. Arteriovenous malformations – current understanding of the pathogenesis with implications for treatment. Int J Mol Sci. 2021; 22(16): 9037. http://doi.org/10.3390/ijms22169037.

15. Kemezh YV. Multispiral computed tomography in diagnostics of pulmonary arteriovenous malformations. Russian Electronic Journal of Radiology. 2013; 3(3): 27–32 (in Russ).

16. Parshin VD, Biriukov IuV, Puretskii MV, et al. Surgical and endovascular treatment of lung arteriovenous malformations. Pirogov Russian Journal of Surgery. 2013; 10: 4–11 (in Russ).

17. Sano A, Tsuchiya T. Thoracoscopic surgery for multiple peripheral pulmonary arteriovenous fistulas. Ann Thorac Surg. 2015; 99(5): 1808–9. http://doi.org/10.1016/j.athoracsur.2014.08.047.

18. Shimohira M, Kawai T, Hashizume T, et al. Reperfusion rates of pulmonary arteriovenous malformations after coil embolization: evaluation with time-resolved MR angiography or pulmonary angiography. J Vasc Interv Radiol. 2015; 26(6): 856–64. http://doi.org/10.1016/j.jvir.2015.02.016.