Figure 9d. Thrombosis of the left upper PV in a 31-year-old man presenting with hemoptysis and transient discomfort of 3 months duration in the left side of the chest. RF ablation in the left superior PV had been performed for refractory atrial fibrillation 4 months earlier. The patient also received anticoagulant drug therapy. (a) Posteroanterior chest radiograph shows poorly demarcated opacities suggestive of asymmetric edema in the left upper lobe. (b, c) Axial contrast-enhanced CT scans (lung window) show diffuse ground-glass attenuation (arrows in b) and focal peripheral consolidation (arrow in c) in the left upper lobe, consistent with pulmonary venous infarction. Note the thickened interlobular septum (arrowhead in b) and the small pleural effusion. (d) Axial contrast-enhanced CT scan (mediastinal window) shows occlusion of the left superior PV (arrow), with soft-tissue attenuation surrounding the expected location of the vein. (Case courtesy of H. Page McAdams, MD, Duke University Medical Center, Durham, NC. Reprinted, with permission, from reference 5.)