Pulmonary arteriovenous fistula is no longer a rare lesion. One variant of this vascular derangement, however, has only twice been noted in the literature.1,2The significance of pulmonary vascular fistulae connected with arteries of the chest wall lies both in the differences in clinical manifestations and in the problems which may be encountered in their surgical management. Report of Case A 24-year-old single Negro soldier was admitted to the Valley Forge Army Hospital on June 27, 1956. He had been originally seen two days before at the U. S. Army Hospital, Aberdeen, Md., where he complained of having had fever and chills since June 9. He had had a productive cough since that time, associated with severe chest pain and production of green-colored sputum. Three days after onset of his symptoms, he was confined to quarters and given penicillin for two days. He was subsequently x-rayed and continued on