A Case of Incidentally Discovered Primary Pulmonary Vein Stenosis in an Adult

Primary pulmonary vein stenosis (PPVS) in adults is rare and often incidentally detected on imaging. A 60-year-old man underwent chest CT for respiratory symptoms, revealing a localized reticulonodular opacity in the right upper lung field near the pulmonary hilum. Coronal and sagittal reconstructions demonstrated tortuous collateral veins bridging the right superior and inferior pulmonary veins. Mediastinal-window images confirmed severe stenosis of the proximal right superior pulmonary vein without evidence of external compression or congenital anomaly. As symptoms resolved spontaneously, conservative management was chosen. This case demonstrates that axial reticulonodular opacities can raise suspicion of PPVS, with multiplanar and mediastinal-window imaging enabling accurate diagnosis of this rare condition.