Lung Cancer-Like Presentation of Pulmonary Vein Stenosis After Radiofrequency Catheter Ablation for Atrial...

A woman in her 50s presented with a two-month history of haemoptysis, dyspnea, cough and weight loss. She had recently undergone radiofrequency ablation for atrial fibrillation. A computed tomography (CT) scan of her chest showed left upper lobe opacity, mediastinal lymphadenopathy, and left pleural effusion, concerning for malignancy. Bronchoscopy revealed a malignant-appearing lesion that was negative for malignancy on biopsy. Despite improvement of the CT abnormalities and the lesion on a repeat bronchoscopy, she continued to experience recurrent episodes of dyspnea and haemoptysis. A ventilation/perfusion scan showed decreased perfusion to her left lung. A CT pulmonary angiogram with pulmonary vein phase established the diagnosis of pulmonary vein stenosis. This case highlights the necessity of considering pulmonary vein stenosis in patients post-ablation presenting with features suggestive of lung cancer to avoid unnecessary delays in diagnosis and treatment.