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Li M, Zhu WY, Wu RR, Wang L, Mo MT, Liu SN, Zhu DY, Luo Z. Pulmonary artery aneurysm protruding into the bronchus as an endobronchial mass: A case report. World J Clin Cases 2023; 11:6792-6796. [PMID: 37901013 PMCID: PMC10600857 DOI: 10.12998/wjcc.v11.i28.6792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/11/2023] [Accepted: 09/06/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND Pulmonary artery (PA) aneurysms are usually diagnosed radiographically and present as small or large lesions resembling inflammation or a neoplasm on chest radiography. It has rarely been reported as an endobronchial mass. CASE SUMMARY We report the case of a 64-year-old man who presented with recurrent hemoptysis. Bronchoscopy revealed a tumorous protrusion blocking the right middle lobe bronchus, which was confirmed to be a PA aneurysm using endobronchial ultrasound bronchoscopy and computed tomography angiography. CONCLUSION Although endobronchial PA aneurysms are rare, bronchoscopists need to add this lesion to the list of endobronchial masses for which a biopsy is to be assiduously avoided.
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Affiliation(s)
- Min Li
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan Province, China
| | - Wen-Ye Zhu
- Department of Pharmacy, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan Province, China
| | - Rong-Rong Wu
- Department of Radiology, The First People’s Hospital of Yunnan Province/Affiliated Hospital of Kunming University of Science and Technology, Kunming 650034, Yunnan Province, China
| | - Le Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan Province, China
| | - Meng-Ting Mo
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan Province, China
| | - Shi-Nan Liu
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan Province, China
| | - Dong-Yi Zhu
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan Province, China
| | - Zhuang Luo
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan Province, China
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Aspergillus Mimicking a Rasmussen Aneurysm in an Immunocompromised Setting Causing Massive Hemoptysis. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2020. [DOI: 10.1097/ipc.0000000000000878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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3
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Benhassen LL, Højsgaard A, Allan Terp K, de Paoli FV. Surgical approach to a mycotic aneurysm of the pulmonary artery presenting with hemoptysis - A case report and a review of the literature. Int J Surg Case Rep 2018; 50:92-96. [PMID: 30092541 PMCID: PMC6086216 DOI: 10.1016/j.ijscr.2018.07.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 07/16/2018] [Accepted: 07/24/2018] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Mycotic aneurysms of the pulmonary arteries are very rare and have high mortality. Risk groups are intravenous drug users and patients with congenital heart disorders. The surgical approach varies due to a limited number of reported cases. PRESENTATION OF CASE We present a case of a mycotic aneurysm of the right pulmonary artery in a 56-year old man presenting with recurrent pneumonias, weight loss and hemoptysis. DISCUSSION There is often a diagnostic delay because of non-specific symptoms mimicking more common disorders. Treatment strategies include conservative management, surgery and endovascular treatment. CONCLUSION This report demonstrates a rare case of aneurysm of the pulmonary artery presenting with hemoptysis. For rapidly progressing proximal aneurysms of the pulmonary arteries, the midline surgical approach is recommended.
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Affiliation(s)
- Leila Louise Benhassen
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Palle-Juul Jensens Boulevard 99, DK-8200, Aarhus N, Denmark.
| | - Anette Højsgaard
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Palle-Juul Jensens Boulevard 99, DK-8200, Aarhus N, Denmark
| | - Kim Allan Terp
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Palle-Juul Jensens Boulevard 99, DK-8200, Aarhus N, Denmark
| | - Frank Vincenzo de Paoli
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Palle-Juul Jensens Boulevard 99, DK-8200, Aarhus N, Denmark; Department of Biomedicine, Aarhus University, Vennelyst Boulevard 4, DK-8000, Aarhus C, Denmark
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4
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Valente T, Abu-Omar A, Sica G, Clemente A, Muto M, Bocchini G, Cappabianca S, Rea G. Acquired peripheral pulmonary artery aneurysms: morphological spectrum of disease and multidetector computed tomography angiography findings-cases series and literature review. Radiol Med 2018; 123:664-675. [PMID: 29721920 DOI: 10.1007/s11547-018-0900-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 04/20/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND Acquired peripheral or intraparenchymal pulmonary artery aneurysms (PPAA) are rare entities but are important to recognize because of the associated morbidity. Hemoptysis is their principal complication and is a potentially fatal condition. PURPOSE To illustrate the causes, multidetector CT angiography (MDCTA) findings and differential diagnosis of acquired PPAA. MATERIALS AND METHODS The institutional review boards approved this study. We conducted a retrospective review of the demographic data and the results of clinical and laboratory examinations, and imaging studies of patients managed between January 2012 and January 2017 in two institutions. RESULTS A total of 19 patients had acquired PPAA that were detected at MDCTA, 9 patients with normal pulmonary artery pressures and 10 with pulmonary hypertension. Nine patients developed PPAA-related acute symptoms. MDCTA features of PPAA include: a lobulated vascular mass, an indistinct irregular arterial wall, aneurysmal thrombosis or wall calcification, findings of impending rupture including perianeurysmal edema, gas or a soft tissue mass. CONCLUSION PPAA are rare. In our series, endocarditis and pulmonary hypertension are the PPAA leading causes. The treatment modality preferred is embolization, especially as surgery poses a very high risk for patients with severe pulmonary hypertension. Further clarification of the natural history of these rare arterial aneurysms is needed.
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Affiliation(s)
- Tullio Valente
- Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, P.O. Monaldi, Via Leonardo Bianchi, 80131, Naples, Italy.
| | - Ahmad Abu-Omar
- Department of Radiology, The James Cook University Hospital NHS Trust, Marton Road, Middlesbrough, TS4 3BW, UK
| | - Giacomo Sica
- Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, P.O. Monaldi, Via Leonardo Bianchi, 80131, Naples, Italy
| | - Alfredo Clemente
- Department of Radiology and Radiotherapy, University of Campania "Luigi Vanvitelli", Piazza Miraglia, 80138, Naples, Italy
| | - Massimo Muto
- Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, P.O. Monaldi, Via Leonardo Bianchi, 80131, Naples, Italy
| | - Giorgio Bocchini
- Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, P.O. Monaldi, Via Leonardo Bianchi, 80131, Naples, Italy
| | - Salvatore Cappabianca
- Department of Radiology and Radiotherapy, University of Campania "Luigi Vanvitelli", Piazza Miraglia, 80138, Naples, Italy
| | - Gaetano Rea
- Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, P.O. Monaldi, Via Leonardo Bianchi, 80131, Naples, Italy
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5
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Sunagawa K, Uchino Y, Ishimoto S, Nakamura S, Honma T, Nakanishi Y, Hatta Y, Miyazaki Y, Sakurai H, Hao H, Sugitani M. Mycotic pseudoaneurysm of a pulmonary artery branch caused by Cladosporium. Pathol Int 2017; 68:47-52. [PMID: 29193597 DOI: 10.1111/pin.12615] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Accepted: 11/04/2017] [Indexed: 11/28/2022]
Abstract
We report the case of a 53-year-old male with a history of acute myelogenous leukemia, who suffered the rupturing of a right-sided pulmonary artery pseudoaneurysm combined with pneumonia. He underwent a right-sided lower lobectomy. The resected lung tissue demonstrated a mycotic pseudoaneurysm of a pulmonary artery branch together with a filamentous fungal infection. Pseudoaneurysms are caused by the breaching of all layers of a blood vessel wall. The extravasated blood is trapped by the surrounding extravascular tissue or clots. Cladosporium was detected during a polymerase chain reaction-based analysis followed by DNA sequencing of formalin-fixed paraffin-embedded lung tissue samples. Although previous cases of pulmonary artery pseudoaneurysms caused by fungal infections, e.g., Candida or Aspergillus sp., have been reported, to the best of our knowledge this is the first case to involve cladosporiosis.
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Affiliation(s)
- Keishin Sunagawa
- Department of Pathology, Showa University, Shinagawa-ku, Tokyo, Japan.,Department of Pathology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan.,Department of Pathology, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan
| | - Yoshihito Uchino
- Department of Hematology and Rheumatology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Shinichirou Ishimoto
- Department of Respiratory Surgery, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Shigeki Nakamura
- Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan
| | - Taku Honma
- Department of Pathology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Yoko Nakanishi
- Department of Pathology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Yoshihiro Hatta
- Department of Hematology and Rheumatology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Yoshitsugu Miyazaki
- Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan
| | - Hiroyuki Sakurai
- Department of Respiratory Surgery, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Hiroyuki Hao
- Department of Pathology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Masahiko Sugitani
- Department of Pathology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
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6
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Reisenauer JS, Said SM, Schaff HV, Connolly HM, Maleszewski JJ, Dearani JA. Outcome of Surgical Repair of Pulmonary Artery Aneurysms: A Single-Center Experience With 38 Patients. Ann Thorac Surg 2017. [DOI: 10.1016/j.athoracsur.2017.03.077] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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7
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Kumar R, Wales CJ, Fisher M. Pulmonary Artery Aneurysm Presenting as Solitary Pulmonary Nodule. Scott Med J 2016. [DOI: 10.1258/rsmsmj.51.2.54e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- R Kumar
- Department of Diabetology, Glasgow Royal Infirmary, Glasgow G4 0SF, UK
| | - CJ Wales
- Department of Diabetology, Glasgow Royal Infirmary, Glasgow G4 0SF, UK
| | - M Fisher
- Department of Diabetology, Glasgow Royal Infirmary, Glasgow G4 0SF, UK
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8
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Abstract
OBJECTIVE The purpose of this study was to analyze the clinical and CT features of pulmonary artery pseudoaneurysms (PAPs). MATERIALS AND METHODS A database search of chest CT examinations performed from January 1, 2000 to December 31, 2014 identified 24 patients with findings consistent with PAPs. A CT finding consistent with a PAP was defined as a focal saccular outpouching of a pulmonary artery. Medical records were reviewed to determine clinical presentations, treatments, and outcomes. CT scans were reviewed by two board-certified fellowship-trained chest radiologists. RESULTS A total of 35 PAPs were identified in 24 patients. Hemoptysis and shortness of breath were the most common presenting symptoms. The most commonly identified causes of PAPs were infection (33%), neoplasms (13%), and trauma (17%). Of the 35 PAPs, 29 (83%) were located in segmental or subsegmental pulmonary arteries. A solitary PAP was identified in 20 (83%) patients, and multiple PAPs were identified in three patients with endocarditis and one patient with pulmonary metastases. Only three of 35 (9%) PAPs were associated with a ground-glass halo. Endovascular treatment was successfully performed in 12 patients, and only one patient had immediate recurrent hemoptysis after treatment. PAP was clinically suspected by the referring clinicians in only three patients. Sixteen of the 35 (46%) PAPs were not reported on the initial CT studies. CONCLUSION PAPs showed a strong predilection for the peripheral pulmonary arteries. Multiplicity of PAPs can be seen in the settings of endocarditis and pulmonary metastatic disease. Most PAPs were not associated with a ground-glass halo. PAPs can be lethal but were often not suspected clinically and were underreported by radiologists.
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9
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del Barco O, Kim W, Moeslein F, Shet N. Ultrasound-Aided Diagnosis of Pulmonary Artery Pseudoaneurysm in a Pediatric Patient. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2016. [DOI: 10.1177/8756479315613942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Pulmonary artery pseudoaneurysm (PAP) is an uncommon entity associated with high mortality if left untreated. PAPs are most often acquired secondary to trauma, inflammation, infection, or malignancy. The most common presentation is hemoptysis, but many patients are asymptomatic. Because of the increased risk of enlargement and rupture, timely diagnosis and intervention is necessary. Imaging plays an essential role not only in diagnosis of this entity but also in intervention. We describe a case using gray-scale and color Doppler imaging providing sonographically aided diagnosis and follow-up of a clinically silent PAP in a pediatric patient.
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Affiliation(s)
| | - Wendy Kim
- University of Maryland Medical Center, Baltimore, MD, USA
| | - Fred Moeslein
- University of Maryland Medical Center, Baltimore, MD, USA
| | - Narendra Shet
- University of Maryland Medical Center, Baltimore, MD, USA
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10
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Bezgin T, Demircan HC, Kaymaz C. Giant pulmonary artery aneurysm secondary to patent ductus arteriosus: a case report. Curr Cardiol Rev 2014; 11:163-6. [PMID: 25545802 PMCID: PMC4356724 DOI: 10.2174/1573403x1102141224145247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 07/10/2014] [Accepted: 07/14/2014] [Indexed: 11/23/2022] Open
Abstract
Aneurysms involving the main pulmonary artery and its branches are rare. Clinical experience is limited, and their management is not well established. We present the case of a 35-year-old male patient with dyspnea and hemoptysis in whom subsequent imaging studies revealed a giant pulmonary artery aneurysm associated with an uncorrected patent ductus arteriosus and Eisenmenger’s syndrome. We chose to treat the patient conservatively with medical management due to the development of Eisenmenger’s physiology while waiting for heart-lung transplantation.
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Affiliation(s)
| | | | - Cihangir Kaymaz
- Kartal Kouyolu Heart Research Hospital, Denizer Cad. 34846 Cevizli Kartal-stanbul, Turkey.
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11
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Abstract
Mycotic pulmonary artery aneurysms are rare but potentially fatal complications of infective endocarditis. The literature on this rare condition was reviewed and its management is discussed.
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Affiliation(s)
- Taobo Luo
- Department of Cardiovascular Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China
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12
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Lerner AD, Riker DR. Use of endobronchial ultrasonography in the diagnosis of a pulmonary artery aneurysm. Ann Thorac Surg 2014; 97:e139-41. [PMID: 24792302 DOI: 10.1016/j.athoracsur.2013.12.083] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2013] [Revised: 12/02/2013] [Accepted: 12/30/2013] [Indexed: 10/25/2022]
Abstract
We present the case of an 84-year-old man with nonmassive hemoptysis and an obstructing endobronchial mass who was referred for rigid bronchoscopy and biopsy of the lesion. We illustrate how the pulsatile movement of his endobronchial lesion could be differentiated by convex probe endobronchial ultrasound bronchoscopy to be a vascular lesion rather than an endobronchial mass or tumor. Although convex probe endobronchial ultrasonography has many mediastinal applications, it has yet to be used to characterize endobronchial masses. We describe the first case of using convex probe endobronchial ultrasonography in the diagnosis of a left upper lobe pulmonary artery aneurysm presenting as an endobronchial mass.
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Affiliation(s)
- Andrew D Lerner
- Interventional Pulmonology Division, University of California, San Diego Medical Center, San Diego, California
| | - David R Riker
- Interventional Pulmonology Division, University of California, San Diego Medical Center, San Diego, California.
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13
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Pulmonary artery aneurysm in an octogenarian with operated secundum atrial septal defect. Herz 2013; 39:657-60. [PMID: 23989764 DOI: 10.1007/s00059-013-3887-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 06/05/2013] [Accepted: 06/17/2013] [Indexed: 10/26/2022]
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14
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Garnett GM, Kimball S, Kon K, Woo RK. Pulmonary artery pseudoaneurysm after MRSA septicemia in a pediatric patient. J Pediatr Surg 2013; 48:E33-6. [PMID: 23701806 DOI: 10.1016/j.jpedsurg.2013.03.070] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 03/25/2013] [Accepted: 03/28/2013] [Indexed: 10/26/2022]
Abstract
We document a previously unreported case of a pulmonary artery pseudoaneurysm (PAP) that developed in a pediatric patient initially presenting with Methicillin-resistant Staphylococcus aureus hip joint sepsis. This is the first reported case of PAP of infectious origin in a pediatric patient, and this case is unique as the evolution of the PAP was documented by computed tomography.
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Affiliation(s)
- Gwendolyn M Garnett
- Department of Surgery, University of Hawai'i, John A. Burns School of Medicine, Honolulu, HI 96826, USA
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15
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Lotan E, Springer J, McWilliams JP, Rimon U, Abtin F. Percutaneous embolization of an incidentally diagnosed pulmonary aneurysm in a scleroderma patient. J Radiol Case Rep 2012; 6:29-34. [PMID: 23378880 DOI: 10.3941/jrcr.v6i6.922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A 59-year-old female with history of progressive scleroderma and pulmonary fibrosis was referred for biopsy of a pulmonary nodule that was discovered on computed-tomography (CT) chest surveillance, not present on prior CT- scan. Imaging was suspicious for granuloma, malignancy or aneurysm. CT- Angiography (CTA), performed immediately before the procedure, did not show enhancement of the mass, followed by placement of coaxial-needle into the mass. Suspicion of aneurysm was again raised and repeat CTA demonstrated contrast filling of the aneurysm. With the coaxial-needle in the aneurysm, embolization of the sac was performed using microfibrillar collagen, followed by confirmation of containment and thrombosis with CT.
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Affiliation(s)
- Eyal Lotan
- Department of Diagnostic Radiology, Sheba Medical Center, Tel Aviv University, Israel
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16
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Vivas R, Carvajal LF, Gómez JF, Guzmán M, Díaz LH, Lince R, Ruz M, Donado JR. Aneurismas de la arteria pulmonar. Reporte de un caso y revisión de la literatura. REVISTA COLOMBIANA DE CARDIOLOGÍA 2011. [DOI: 10.1016/s0120-5633(11)70192-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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17
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[Aneurysmal dilatation of pulmonary artery and its branches on mitral stenosis: a case report]. Ann Cardiol Angeiol (Paris) 2011; 62:60-3. [PMID: 21292235 DOI: 10.1016/j.ancard.2010.12.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2009] [Accepted: 12/24/2010] [Indexed: 11/21/2022]
Abstract
Pulmonary arteries aneurysms are rare and the rarely described bilateral aneurysms. A 45-year-old patient carrier of mitral stenosis was admitted for dyspnoea class III of the NYHA, chest pain and a not infectious cough. The clinical examination found semiology of mitral stenosis, tricuspid incapacity and pulmonary arterial hypertension. The electrocardiogram showed atrial fibrillation and right ventricle hypertrophy. Chest X-ray found a cardiomegaly, an aspect of double outline of the inferior right bow, a prominent aspect of the left average bow reminding an aneurysm of the left pulmonary artery. The echocardiography Doppler found a pure tight mitral stenosis (mitral surface=0.6 cm(2)), a dilation of the trunk of the pulmonary artery (diameter=74 mm) and of its branches (diameter of the right pulmonary artery=28 mm, diameter of the left pulmonary artery=36 mm) seat of a spontaneous contrast. The left atrium and right cardiac cavities were also dilated. There was an important tricuspid incapacity with a major pulmonary hypertension (systolic pulmonary arterial=109 mmHg). The thoracic angioscan showed a pseudoaneurysm of the trunk of pulmonary artery and its branches to their distal parts. Under diuretic, anticoagulating and analgesic treatment the clinical signs improved however the spontaneous contrast persisted. The patient was rejected by the surgery for exceeded clinical board. She is at present followed in our service for 5 months.
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18
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Fakler U, Mebus S, Kaemmerer H, Will A, Eicken A, Weiss M, Reichard B, Hess J. A ticking time bomb--high pressure pulmonary artery aneurysm. Am J Med 2008; 121:777-80. [PMID: 18724967 DOI: 10.1016/j.amjmed.2008.06.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2007] [Revised: 05/31/2008] [Accepted: 06/02/2008] [Indexed: 11/18/2022]
Affiliation(s)
- Ullrich Fakler
- Klinik für Kinderkardiologie und angeborene Herzfehler, Deutsches Herzzentrum München, Technische Universität München, Germany.
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19
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Multiple Mycotic Aneurysms of the Pulmonary Arteries Resolving With Conservative Management. J Thorac Imaging 2008; 23:197-201. [DOI: 10.1097/rti.0b013e318176b917] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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20
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Saida T, Ninomiya H, Yamasaki M, Yamauchi T. Mycotic pulmonary artery aneurysm as a late complication of infective endocarditis after pacemaker implantation. ACTA ACUST UNITED AC 2007; 25:240-2. [PMID: 17581714 DOI: 10.1007/s11604-007-0124-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2006] [Accepted: 01/25/2007] [Indexed: 11/28/2022]
Abstract
A 49-year-old-woman who had had a pacemaker implanted 15 years earlier became acutely ill with a continuous high fever and general fatigue. A pulmonary artery aneurysm had been rapidly developing and had arrived at the acute phase within 2 weeks. After removal of the pacemaker and with antibiotic therapy the aneurysm gradually decreased in size and has been without rupture for 3 years. Conservative treatment seemed to be sufficient for the management of a mycotic aneurysm in this case.
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Affiliation(s)
- Tsukasa Saida
- Department of Diagnostic Radiology and Interventional Radiology, Tsukuba University Hospital, 2-1-1 Amakubo, Tsukuba, 305-8558, Japan.
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21
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Ichimura H, Okazaki H, Kikuchi K, Saitoh T, Haraguchi N, Onizuka M. A pseudoaneurysmal cyst in the pulmonary artery secondary to lung suppuration. J Thorac Cardiovasc Surg 2007; 133:1678-9. [PMID: 17532991 DOI: 10.1016/j.jtcvs.2007.01.072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2006] [Accepted: 01/08/2007] [Indexed: 10/23/2022]
Affiliation(s)
- Hideo Ichimura
- Department of General Thoracic Surgery, Tsukuba Medical Center Hospital, Ibaraki, Japan.
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22
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Castañer E, Gallardo X, Rimola J, Pallardó Y, Mata JM, Perendreu J, Martin C, Gil D. Congenital and acquired pulmonary artery anomalies in the adult: radiologic overview. Radiographics 2006; 26:349-71. [PMID: 16549603 DOI: 10.1148/rg.262055092] [Citation(s) in RCA: 103] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Various congenital and acquired anomalies may affect the pulmonary arteries in adult patients. Congenital anomalies (proximal interruption, anomalous origin of the left pulmonary artery [pulmonary artery sling], and idiopathic dilatation of the pulmonary trunk) are usually found incidentally at chest radiography or computed tomography (CT). Acquired anomalies include diffuse or focal enlargement of the arteries because of pulmonary hypertension, aneurysm, and intravascular pulmonary metastasis; decreased arterial diameter because of bronchial carcinoma, mediastinal fibrosis, and Takayasu arteritis; and intraluminal filling defects due to pulmonary thromboembolism and pulmonary artery sarcoma. An awareness of the radiologic manifestations of the disease entities and potential pulmonary artery complications secondary to infection or vasculitis may enable an early diagnosis. CT angiography is becoming the standard method for evaluating patients in whom the presence of pulmonary embolism is suspected. CT assessment of the extent of heart effects in patients with pulmonary hypertension and pulmonary embolism is particularly important because such effects largely determine the prognosis.
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Affiliation(s)
- Eva Castañer
- Department of Radiology, SDI UDIAT-CD, Institut Universitari Parc Taulí-UAB, Corporació Parc Taulí, Parc Taulí s/n, Sabadell 08208, Barcelona, Spain.
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23
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Lee CC, Adamson D, Madani M, Manecke GR. Transesophageal Echocardiography and the Intraoperative Diagnosis of a Right Pulmonary Artery Aneurysm. J Cardiothorac Vasc Anesth 2006; 20:562-4. [PMID: 16884989 DOI: 10.1053/j.jvca.2005.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2004] [Indexed: 11/11/2022]
Affiliation(s)
- Christian C Lee
- Department of Anesthesiology and Surgery, UCSD Medical Center, San Diego, CA, USA
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24
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Pulmonary artery aneurysm repair with Mersilene Mesh: Report of a case. Indian J Thorac Cardiovasc Surg 2006. [DOI: 10.1007/s12055-006-0023-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Kim HS, Oh YW, Noh HJ, Lee KY, Kang EY, Lee SY. Mycotic pulmonary artery aneurysm as an unusual complication of thoracic actinomycosis. Korean J Radiol 2004; 5:68-71. [PMID: 15064561 PMCID: PMC2698115 DOI: 10.3348/kjr.2004.5.1.68] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Although pulmonary artery aneurysms are a rare vascular anomaly, they are seen in a wide variety of conditions, such as congenital heart disease, infection, trauma, pulmonary hypertension, cystic medial necrosis and generalized vasculitis. To our knowledge, mycotic aneurysms caused by pulmonary actinomycosis have not been reported in the radiologic literature. Herein, a case of pulmonary actinomycosis complicated by mycotic aneurysm is presented. On CT scans, this case showed focal aneurysmal dilatation of a peripheral pulmonary artery within necrotizing pneumonia of the right lower lobe, which was successfully treated with transcatheter embolization using wire coils.
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Affiliation(s)
- Hyung Soo Kim
- Department of Radiology, Gunpo Hospital, Wonkwang University College of Medicine, Korea
| | - Yu-Whan Oh
- Department of Radiology, Korea University Hospital and Korea University College of Medicine, Korea
| | - Hyung Jun Noh
- Department of Radiology, Korea University Hospital and Korea University College of Medicine, Korea
| | - Ki Yeol Lee
- Department of Radiology, Korea University Hospital and Korea University College of Medicine, Korea
| | - Eun-Young Kang
- Department of Radiology, Korea University Hospital and Korea University College of Medicine, Korea
| | - Sang Yeub Lee
- Department of Internal Medicine, Korea University College of Medicine, Korea
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26
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Abstract
This article reviews common cardiovascular pathologies that can be noted first on plain film when previously unsuspected, and then illustrates how cross-sectional imaging can provide the follow-up information needed to make a diagnosis. First reviewed are the normal cardiac structures and contours as seen on the plain film of the chest, followed by specific types of pathologies as seen in older adults; patients with lung cancer invading the heart, pericardium, or large vessels; and postsurgical and posttraumatic findings. Also provided is a review of non-cardiac-related areas of plain film and cross-sectional imaging correlation. It is hoped that the reader gains a better understanding and appreciation for the great value of cross-sectional imaging, and the power of the plain film in helping detect and recognize thoracic pathology.
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Affiliation(s)
- André J Duerinckx
- Radiology Service, Veterans Affairs North Texas Healthcare System, Dallas, TX 75126, USA.
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27
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Dransfield MT, Johnson JE. A Mycotic Pulmonary Artery Aneurysm Presenting as an Endobronchial Mass. Chest 2003; 124:1610-2. [PMID: 14555599 DOI: 10.1378/chest.124.4.1610] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
We report the case of a 49-year-old woman who developed an endobronchial mycotic pulmonary artery aneurysm (PAA) as a complication of pneumonia. After presenting with patchy infiltrates, she developed right lung atelectasis. A noncontrast chest CT scan revealed a mass in the right hilum, and bronchoscopy identified an obstructing lesion in the right mainstem bronchus. Unfortunately, biopsy caused massive hemorrhage, and the patient died. An autopsy identified a mycotic PAA that had invaded the right mainstem. The case suggests that a contrasted CT scan should be included in the evaluation of endobronchial masses and that PAA should be included in the differential diagnosis of such lesions.
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28
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Pereira de Godoy JM, Batigália F. Bilateral pulmonary artery aneurysm associated with bilateral pulmonary thromboembolism, superior vena caval thrombosis, and Chagas' disease--a case report. Angiology 2000; 51:609-14. [PMID: 10917587 DOI: 10.1177/000331970005100711] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The authors report a case of bilateral pulmonary artery aneurysm in a patient with chronic Chagas' disease and compensated congestive heart failure in whom clinical clues suggested pulmonary thromboembolism, and the actual nature of the lesions was discovered at the time of conventional imaging investigations. This case shows the rarity of bilateral pulmonary aneurysm associated with bilateral pulmonary thromboembolism and the importance of an awareness of this condition in the differential diagnosis for lung masses.
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Affiliation(s)
- J M Pereira de Godoy
- Department of Cardiology and Vascular Surgery, São José do Rio Preto University School of Medicine, São Paulo, Brasil.
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29
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