1
|
Lukic A, Cmelak L, Draženović D, Kojundzic H, Lukic IK, Gluncic V. Pulmonary Arteriovenous Malformation Unmasked by Pregnancy: A Review of Pulmonary Arteriovenous Malformations and Cardiovascular and Respiratory Changes in Pregnancy. Case Rep Pulmonol 2023; 2023:5469592. [PMID: 37026089 PMCID: PMC10072959 DOI: 10.1155/2023/5469592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/05/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
Pulmonary arteriovenous malformations are abnormal, direct communications between the branches of the pulmonary artery and pulmonary veins, but without pulmonary capillaries between them. During pregnancy, PAVMs can enlarge and become symptomatic, causing even serious complications like haematothorax. To recognize the PAVM that becomes symptomatic in pregnancy, one must be able to distinguish the patient’s symptoms caused by developing complications of PAVM, as in the case we present, from physiological changes accompanying a healthy pregnancy, including their degree in relation to the stage of pregnancy. The modified early obstetric warning score charts are a very helpful tool in the assessment of (ab)normal signs and symptoms in pregnant women, especially for physicians who rarely manage pregnant women.
Collapse
|
2
|
Ladeira I, Neves S, Almeida J, Parente B, Couceiro A, Moura Sá J. Diffuse vascular hamartoma with malignant behavior. Respir Med Case Rep 2015; 15:125-7. [PMID: 26236622 PMCID: PMC4501529 DOI: 10.1016/j.rmcr.2015.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 05/07/2015] [Accepted: 05/08/2015] [Indexed: 10/28/2022] Open
Abstract
Pulmonary hamartomas are benign lesions, usually asymptomatic and incidentally discovered on a routine chest radiograph; occasionally, however, this benign lesion may cause life threatening symptoms due to it's location and diffuse vascular involvement. We report the case of a 27 year-old male, non-smoker, who presented with dyspnea, cough, hemoptysis and weight loss. He was found to have a mass in the right hilar region which also involved the right main bronchus, pulmonary artery and esophagus. Surgical biopsy of the lesion led to the diagnosis of diffuse vascular hamartoma. Although it was a benign lesion, due to the size and location, surgical removal was not possible and patient died 10 years after being diagnosed with the condition.
Collapse
Affiliation(s)
- I Ladeira
- Bronchoscopy Unit, Pulmonology Department, Centro Hospitalar de Gaia-Espinho, EPE, Portugal
| | - S Neves
- Bronchoscopy Unit, Pulmonology Department, Centro Hospitalar de Gaia-Espinho, EPE, Portugal
| | - J Almeida
- Bronchoscopy Unit, Pulmonology Department, Centro Hospitalar de Gaia-Espinho, EPE, Portugal
| | - B Parente
- Pulmonary Oncology Unit, Pulmonology Department, Centro Hospitalar de Gaia-Espinho, EPE, Portugal
| | - A Couceiro
- Pathology Department, Centro Hospitalar de Gaia-Espinho, EPE, Portugal
| | - J Moura Sá
- Bronchoscopy Unit, Pulmonology Department, Centro Hospitalar de Gaia-Espinho, EPE, Portugal
| |
Collapse
|
3
|
Shafiek H, Gómez C, Pierola J, Sauleda J, Cosío BG. Probe-Based Confocal Laser Endomicroscopy Imaging of Endobronchial Hamartomas. Respiration 2014; 88:484-6. [DOI: 10.1159/000368085] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 08/04/2014] [Indexed: 11/19/2022] Open
|
4
|
Abstract
Endobronchial hamartoma is an unusual clinical entity and infrequently causes hemoptysis. This brief report extends the sparse available experience with endobronchial hamartoma causing hemoptysis by presenting, to our knowledge, only the third such patient reported to have massive hemoptysis complicating an endobronchial hamartoma.
Collapse
|
5
|
Endobronchial lipomatous hamartoma: an incidental finding in a patient with atrial fibrillation-a case report. Case Rep Med 2012; 2012:897581. [PMID: 22431943 PMCID: PMC3295585 DOI: 10.1155/2012/897581] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Accepted: 11/10/2011] [Indexed: 11/24/2022] Open
Abstract
Introduction. Lung hamartomas are the most common benign tumors of the lung. Typically,
they are located in the peripheral lung, while an endobronchial localisation is rare. Case Presentation. We present a case with the rare diagnosis of an endobronchial hamartoma as incidental finding in a 69-year-old male, caucasian patient with atrial
fibrillation. At first admission, the patient's exertional dyspnea was caused by atrial fibrillation. Relapse of exertional dyspnea in the absence of arrhythmia was due to postobstructive pneumonia caused by an endobronchial hamartoma. Conclusion. Endobronchial tumors such as endobronchial lipoma or hamartoma should be considered as potential causes of exertional dyspnea and thus as differential diagnosis of
atrial fibrillation. Although endobronchial hamartomas are benign, resection is recommended to prevent postobstructive lung damage.
Collapse
|
6
|
Zhao Y, Li GY, Yang Z, Zhang P, Zhang K, Shao G. Bilateral heterochronic spontaneous hemothorax caused by pulmonary arteriovenous malformation in a gravid: a case report. J Cardiothorac Surg 2010; 5:96. [PMID: 21034516 PMCID: PMC2987927 DOI: 10.1186/1749-8090-5-96] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2010] [Accepted: 10/31/2010] [Indexed: 11/12/2022] Open
Abstract
Bilateral heterochronic spontaneous hemothorax as a result of pulmonary ateriovenous malformation is a very rarely happened disease. A 34-year-old woman presented major symptoms with right-sided chest pain and shortness of breath. The following contrast-enhanced computed tomographic scan of the chest showed a large amount of fluid in the right thorax with mediastinal shift, but without major vessel injury and 2 small dense opacities in the apical segment of the right lower lobe and in the posterior aspect of the left lower lobe. The patient underwent local resection of the right lower lobe. The pulmonary ateriovenous malformation was further identified by pathological examination. One month after she was discharged home, the symptoms described above recurred. A follow-up computed tomographic scan of the chest showed a large amount of fluid in the left thorax. During the emergency operation, we found a bullous lesion in the left lower lobe and a small blood vessel overlying the lesion that was actively bleeding. As stated above, local resection of the left lower lobe was performed once more. Pathological result was the same as observed previously. There were no postoperative complications and she was discharged from the hospital after two weeks. Two months later, she successfully delivered a healthy female infant. Up to now, regular follow-up observation has shown her to be perfectly asymptomatic.
Collapse
Affiliation(s)
- Yinghao Zhao
- Department of Thoracic Surgery, The Second Hospital of Jilin University, 218 Ziqiang Street, Changchun, China
| | | | | | | | | | | |
Collapse
|
7
|
Abstract
A pulmonary arteriovenous fistula is an abnormal connection between pulmonary arteries and veins. Patients with Rendu-Osler-Weber syndrome may present with this vascular malformation, which is a typical finding of the disease. Approximately 5-15% of Rendu-Osler-Weber syndrome patients have pulmonary arteriovenous malformations (AVM) and there is usually a family history of AVM in these patients. The malformations are usually located in the lower lobes. In this paper, I describe a 49-year-old male patient with dyspnoea, cough, haemoptysis and epistaxis. Physical examination showed nasal telangiectasias, cyanosis of the lips and nails, and a systolic bruit over the left lung. Chest X-ray revealed a 5-cm mass in the left lower lobe and after magnetic resonance examination, together with 3-D magnetic resonance angiography, it was demonstrated to be a pulmonary arteriovenous fistula. The history of a niece with a similiar history of suspected pulmonary arteriovenous fistula led me to consider the possibility of Rendu-Osler-Weber syndrome presenting with a pulmonary arteriovenous fistula.
Collapse
Affiliation(s)
- A M Halefoglu
- Department of Radiology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
| |
Collapse
|
8
|
Cosío BG, Villena V, Echave-Sustaeta J, de Miguel E, Alfaro J, Hernandez L, Sotelo T. Endobronchial hamartoma. Chest 2002; 122:202-5. [PMID: 12114359 DOI: 10.1378/chest.122.1.202] [Citation(s) in RCA: 115] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVES To describe clinical, endoscopic, radiographic, and follow-up characteristics of a series of patients in whom endobronchial hamartoma (EH) had been diagnosed. METHODS Retrospective study of all cases of hamartoma diagnosed by bronchial biopsy between 1974 and 1997 in a tertiary referral hospital in Madrid, Spain. RESULTS EH was diagnosed 47 patients during the study period. Four patients were excluded from the study because no clinical history was available. We analyzed the cases of 43 patients (37 men and 6 women), with a mean (+/- SD) age of 62 +/- 12 years. Seven patients had a concurrent lung neoplasm, and the EH was an incidental endoscopic finding. Among the other 36 patients, 31 had a new onset of respiratory symptoms, most commonly, recurrent respiratory infections in 16 patients (44%) and hemoptysis in a further 12 patients (33.4%). Chest radiograph findings were abnormal in 38 of 43 patients. At bronchoscopy, the lesions were equally distributed throughout the right and left lungs with no clear lobar predilection. Endobronchial obstruction was evident in 26 patients (72.2%) without concurrent neoplasm, 17 of whom underwent resection with a rigid bronchoscope and laser, with total resolution in 13 patients. Partial resolution was achieved in four patients, two of whom needed a second endoscopic procedure. Five patients were treated with open lung surgery. Clinical and endoscopic follow-up was performed in 23 patients at 1 to 73 months (mean, 17 months), and recurrence was found in 4 patients. CONCLUSION EH frequently produces respiratory complaints and radiographic abnormalities. Patients with endobronchial obstructions had satisfactory responses to endoscopic therapy.
Collapse
Affiliation(s)
- Borja G Cosío
- Respiratory Department, Hospital 12 de Octubre, Madrid, Spain.
| | | | | | | | | | | | | |
Collapse
|
9
|
Abstract
Pulmonary arteriovenous malformations (PAVM) are rare pulmonary vascular anomalies. Although most patients are asymptomatic, PAVMs can cause dyspnoea from right-to-left shunt. Because of paradoxical emboli, various central nervous system complications have been described including stroke and brain abscess. There is a strong association between PAVM and hereditary haemorrhagic telangiectasia. Chest radiography and contrast enhanced computed tomography are essential initial diagnostic tools but pulmonary angiography is the gold standard. Contrast echocardiography is useful for diagnosis and monitoring after treatment. Most patients should be treated. Therapeutic options include angiographic embolisation with metal coil or balloon occlusion and surgical excision.
Collapse
Affiliation(s)
- I Khurshid
- Department of Pulmonary and Critical Care Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina 27834, USA.
| | | |
Collapse
|
10
|
Hurt R. Benign tumours of the bronchus and trachea, 1951-1981. Ann R Coll Surg Engl 1984; 66:22-6. [PMID: 6362537 PMCID: PMC2493627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
A review has been made of 128 benign tumours of the bronchus seen at a Regional Thoracic Surgery Centre during the 30-year period, 1951-1981. These have included 74 cases of carcinoid tumour of the bronchus and 38 cases of hamartoma. The similarity of the histological appearances of carcinoid to oat cell carcinoma is stressed, together with its clinical implications. A 5-30-year follow-up of the cases of bronchial carcinoid shows that it is essentially a benign tumour, though late recurrence may occur. The use of the somewhat forgotten technique of a Gebauer skin graft in bronchoplastic surgery is described.
Collapse
|
11
|
Feneley MP, Burns MW. Cerebral abscess: manifestation of pulmonary arteriovenous malformations. AUSTRALIAN AND NEW ZEALAND JOURNAL OF MEDICINE 1983; 13:280-2. [PMID: 6579941 DOI: 10.1111/j.1445-5994.1983.tb04659.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Two cases in which cerebral abscess was the initial presenting feature of pulmonary arteriovenous malformations are reported. Cerebral abscess recurred in one patient. The pulmonary malformations were multiple and bilateral in both cases. One patient had associated features of hereditary hemorrhagic telangiectasia. Surgical resection of the largest malformations was performed in both cases. Cerebral abscess did not recur in either case post-operatively, though this may not have been due to surgical intervention.
Collapse
|
12
|
Serrano Muñoz F, Alix Trueba A, Varela de Ugarte A. Tumores broncopulmonares benignos y tumores primitivos de la traquea. Arch Bronconeumol 1980. [DOI: 10.1016/s0300-2896(15)32461-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
13
|
Solé Montserrat J, Maestre Alcacer J, Astudillo Pombo J, Teixidor Sureda J, Pérez Amorós G, Margarit Traversac F. Hamartoma endobronquial. A proposito de un caso. Arch Bronconeumol 1978. [DOI: 10.1016/s0300-2896(15)32627-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
14
|
Tisell LE, Angervall L, Dahl I, Merck C, Zachrisson BF. Recurrent and metastasizing gastric leiomyoblastoma (epithelioid leiomyosarcoma) associated with multiple pulmonary chondro-hamartomas: long survival of a patient treated with repeated operations. Cancer 1978; 41:259-65. [PMID: 626934 DOI: 10.1002/1097-0142(197801)41:1<259::aid-cncr2820410136>3.0.co;2-m] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
A 15-year-old girl was operated for gastric leiomyoblastoma (epithelioid leiomysocarcoma) with metastasis to a regional lymph node. She has subsequently been operated on twice: once for local recurrence and metastases 9 years after her initial operation and once for an intraabdominal lymph node metastasis. Now, 13 years after her first operation for gastric leiomyoblastoma she is free from symptoms and signs of disease. Preoperative angiography was helpful in diagnosing the recurrence and planning the second operation. Our observations speak in favor of surgical treatment of recurrent and metastasizing gastric leiomyoblastoma. This patient was also operated for multiple pulmonary chondro-hamartomas, primarily suspected to be metastases. Coincidence of gastric leiomyoblastoma and pulmonary chondro-hamartoma does not seem to be due to chance alone.
Collapse
|
15
|
Abstract
Three cases are reported--one endobronchial hamartoma, one endobronchial hamartoma accompanied by a similar intrapulmonary lesion, and one multiple hamartoma. These cases typify the clinical presentation and illustrate some of the difficulties in diagnosis and management. The published cases are reviewed.
Collapse
|
16
|
Fistula arteriovenosa pulmonar en la enfermedad de rendu osler weber. Arch Bronconeumol 1976. [DOI: 10.1016/s0300-2896(15)32730-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
17
|
|
18
|
Poirier TJ, Van Ordstrand HS. Pulmonary chondromatous hamartomas. Report of seventeen cases and review of the literature. Chest 1971; 59:50-5. [PMID: 5099811 DOI: 10.1378/chest.59.1.50] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
|
19
|
|
20
|
|
21
|
Kennedy WP, Milne RM. Endobronchial chondroma presenting as asthma. BRITISH JOURNAL OF DISEASES OF THE CHEST 1969; 63:227-30. [PMID: 5346818 DOI: 10.1016/s0007-0971(69)80023-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
22
|
|
23
|
|