A 19-year-old female was admitted with a 4-year history of recurrent hemoptysis. In the last 2 months, her symptoms had become more severe, frequent, and longer lasting. Her past medical history was significant for 1 episode of pneumonia 10 years ago. She was a pack a day smoker and cannabis user. On physical examination, respiratory sounds were decreased on right hemithorax and her fingers were clubbed. A chest x-ray revealed reduced right lung volume with tracheal shift and attenuation of pulmonary vascular markings at the hilum. Computed tomography of the chest revealed reduced volume and interstitial pattern on the right. Incidentally, right pulmonary veins were not identified. Left lung was free of any anomalies, left pulmonary veins were well visualized and draining into the left atrium.
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