Rare azygous vein aneurysm mimicking an enlarged lymph node

Azygous vein aneurysm (AVA) is an extremely rare condition. Only very few cases have been reported. There are three main causes that are thought to contribute to the aneurysm; trauma, pressure or volume overload and idiopathic. In the majority of the reported cases, this was an incidental finding on an asymptomatic patient on a chest radiograph or Computed Tomography (CT). We report a case of 70 years old Siamese lady who initially presented with crampy epigastric pain for 3 days associated with loss of appetite and loss of weight for 2 months. CT abdomen revealed multiple enlarged mesenteric and aortocaval lymph nodes. Biopsy of the lymph nodes confirmed the diagnosis of lymphoma. Staging CT further revealed multiple enlarged mesenteric lymph nodes. In the midst of this, there was the aneurysmal dilatation of azygous vein. She was treated for her lymphoma and doing well. No intervention was done for the azygous aneurysm. Asymptomatic azygous aneurysm are left alone on monitoring.