Aberrant right subclavian artery (arteria lusoria)
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Lethargy and loss of weight
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Aberrant origin of the right subclavian artery, arising after the left subclavian artery as the 4th aortic arch branch, with a retro-esophageal course to the right side (arteria lusoria).
Irregular focus in the right apicoposterior segment is predominantly linear, most in keeping with scarring. Smaller foci of scarring and several tiny calcified granulomas in the lung apices, and further mild linear scarring in the left lower lobe.
This patient is of Vietnamese origin and presented to primary care complain of lethargy and loss of weight. Aberrant right subclavian artery (arteria lusoria) traversing posterior to the esophagus is evident on CT chest, however it is unlikely to be contributing to his presentation. Scarring and calcification granulomas are also evident on imaging, and based on patient's country of origin are suggestive of pulmonary tuberculosis.