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Pulmonary artery pseudoaneurysm secondary to erosion of tumor into the wall of the middle lobar branches of the right pulomary artery and obstruction of superior lobar branches of the right pulmonary artery due to mass effect from the tumor.

Wells CNW - MedPix (2006)

View Article: MedPix Image - MedPix Case

Affiliation: Tripler Army Medical Center

ABSTRACT

Diagnosis: Pulmonary artery pseudoaneurysm secondary to erosion of tumor into the wall of the middle lobar branches of the right pulomary artery and obstruction of superior lobar branches of the right pulmonary artery due to mass effect from the tumor.

History: 59 year old male with recent diagnosis of right lung non-small cell lung cancer presents with severe hemoptysis.

Findings: A contrast enhanced axial CT image demonstrates a pseudoaneurysm arising from a middle lobar branch of the rightpulmonary artery just proximal to the right inferior lobar artery (often incorrectly called the interlobar artery or artery intermedius). There is complete obstruction of the superior lobar branches of the right pulmonary artery. There is high density consolidation surrounding the lesion representing hemorrhage into the surrounding parenchyma of the lung. The window of the CT image provided does not allow for differentiation of tumor from hemorrhagic consolidation and a comparision image from a prior study would be helpful. After coiling the pseudo were placed no flow is noted in the aneurysm.

Ddx: Pulmonary artery pseudoaneurysm (much more likely to bleed) •infection (especially tuberulosis = Rasmussen’s aneurysm) •tumor invasion •trauma ( especially iatrogenic) Pulmonary artery aneurysm •pulmonary hypertension •pulmonic valve stenosis •Behcet's disease •Takayasu's arteritis •congenital •Hugh Stoven disease Pulmonary artery aneurysm mimic •arterio-venous fistulas

Dxhow: CT pulmonary angiogram

Exam: Severe cachexia, hemodynamic instability, respiratory distress, and a falling hematocrit.

No MeSH data available.


A contrast enhanced axial CT image demonstrates a pedunculated aneurysm arising from the right interlobar pulmonary artery.  There is heterogenous density surrounding the aneurysm which likely represents hemorrhage as well as tumor.
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MPX2374_synpic21447: A contrast enhanced axial CT image demonstrates a pedunculated aneurysm arising from the right interlobar pulmonary artery. There is heterogenous density surrounding the aneurysm which likely represents hemorrhage as well as tumor.


Pulmonary artery pseudoaneurysm secondary to erosion of tumor into the wall of the middle lobar branches of the right pulomary artery and obstruction of superior lobar branches of the right pulmonary artery due to mass effect from the tumor.

Wells CNW - MedPix (2006)

A contrast enhanced axial CT image demonstrates a pedunculated aneurysm arising from the right interlobar pulmonary artery.  There is heterogenous density surrounding the aneurysm which likely represents hemorrhage as well as tumor.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2374&req=5

MPX2374_synpic21447: A contrast enhanced axial CT image demonstrates a pedunculated aneurysm arising from the right interlobar pulmonary artery. There is heterogenous density surrounding the aneurysm which likely represents hemorrhage as well as tumor.

View Article: MedPix Image - MedPix Case

Affiliation: Tripler Army Medical Center

ABSTRACT

Diagnosis: Pulmonary artery pseudoaneurysm secondary to erosion of tumor into the wall of the middle lobar branches of the right pulomary artery and obstruction of superior lobar branches of the right pulmonary artery due to mass effect from the tumor.

History: 59 year old male with recent diagnosis of right lung non-small cell lung cancer presents with severe hemoptysis.

Findings: A contrast enhanced axial CT image demonstrates a pseudoaneurysm arising from a middle lobar branch of the rightpulmonary artery just proximal to the right inferior lobar artery (often incorrectly called the interlobar artery or artery intermedius). There is complete obstruction of the superior lobar branches of the right pulmonary artery. There is high density consolidation surrounding the lesion representing hemorrhage into the surrounding parenchyma of the lung. The window of the CT image provided does not allow for differentiation of tumor from hemorrhagic consolidation and a comparision image from a prior study would be helpful. After coiling the pseudo were placed no flow is noted in the aneurysm.

Ddx: Pulmonary artery pseudoaneurysm (much more likely to bleed) •infection (especially tuberulosis = Rasmussen’s aneurysm) •tumor invasion •trauma ( especially iatrogenic) Pulmonary artery aneurysm •pulmonary hypertension •pulmonic valve stenosis •Behcet's disease •Takayasu's arteritis •congenital •Hugh Stoven disease Pulmonary artery aneurysm mimic •arterio-venous fistulas

Dxhow: CT pulmonary angiogram

Exam: Severe cachexia, hemodynamic instability, respiratory distress, and a falling hematocrit.

No MeSH data available.