[一例伴反复咯血的支气管动脉原发性蔓状血管瘤病例]

[A case of primary racemose hemangioma of bronchial artery with recurrent hemoptysis].

作者信息

Mitsushima H, Masaki H, Oishi K, Akamine S, Oka T, Ayabe H, Ashizawa K, Hayashi K, Hayashi T, Nagatake T

机构信息

Department of Internal Medicine, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, Japan.

出版信息

Nihon Kokyuki Gakkai Zasshi. 2001 Feb;39(2):135-9.

PMID:11321826

Abstract

A 42-year old man was admitted to our hospital because of hemoptysis. Bronchial arteriography revealed a tortuous and dilated left bronchial artery with a shunt formation between the bronchial and pulmonary arteries. Bronchial artery embolization using a sponge was performed three times to treat the hemoptysis, but all attempts failed. The patient therefore underwent left lower lobectomy, after which no hemoptysis was observed. Histopathologically, the resected tissue showed no inflammatory change. Interestingly, abnormal vessels resembling arteriovenous malformations were also found. Although the embolization therapy was effective in several reported cases, we concluded that surgery was required for this patient with persistent hemoptysis because of the development of collaterals and a bronchial-pulmonary artery shunt.

摘要

一名42岁男性因咯血入院。支气管动脉造影显示左支气管动脉迂曲扩张，支气管动脉与肺动脉之间形成分流。为治疗咯血，使用海绵进行了三次支气管动脉栓塞，但均失败。因此，患者接受了左下叶切除术，术后未再出现咯血。组织病理学检查显示，切除的组织无炎症改变。有趣的是，还发现了类似动静脉畸形的异常血管。尽管在一些报道的病例中栓塞治疗有效，但我们得出结论，由于侧支循环的形成和支气管-肺动脉分流，该持续性咯血患者需要进行手术治疗。