Akaishi Satoko, Suga Tatsuo, Kakegawa Satoko, Hoshino Yoichi, Nakagawa Junichi, Aoki Nozomi, Sato Mahito, Maeno Toshitaka, Sando Yoshichika, Hasegawa Akira, Kurabayashi Masahiko
Second Department of Internal Medicine, Gunma University School of Medicine, Maebashi, Japan.
Nihon Kokyuki Gakkai Zasshi. 2002 Aug;40(8):671-4.
We report a case of racemose hemangioma of the right bronchial artery complicated with an atrial septal defect (ASD) and ground-glass opacity localized in the right upper lung lobe. A 42-year-old woman was admitted for the pre-operative assessment of ASD. Aortography and selective angiography revealed that the right bronchial artery was markedly dilated and convoluted, draining into the right intercostal arteries and the right upper pulmonary vein. The patient was suffering from exertional dyspnea, but produced no bloody sputum. Since videobronchoscopy showed normal mucosal findings without bronchiectasis, primary racemose hemangioma of the right bronchial artery was diagnosed, and was treated by ligation of the bronchial artery and patch-closure of the ASD. The ground-glass opacity observed preoperatively in the periphery of the right upper lung lobe vanished after surgery. This opacity was considered to have been localized pulmonary congestion due to augmented hydrostatic pressure in the right upper pulmonary vein, induced by increased pulmonary blood flow through the ASD and the drainage route of the racemose bronchial artery into right upper pulmonary vein.
我们报告一例右支气管动脉蔓状血管瘤合并房间隔缺损（ASD）及右肺上叶磨玻璃影的病例。一名42岁女性因ASD的术前评估入院。主动脉造影和选择性血管造影显示右支气管动脉明显扩张和迂曲，引流至右肋间动脉和右肺上叶静脉。患者有劳力性呼吸困难，但无咯血。由于视频支气管镜检查显示黏膜正常，无支气管扩张，故诊断为右支气管动脉原发性蔓状血管瘤，并通过支气管动脉结扎和ASD修补术进行治疗。术后，术前在右肺上叶周边观察到的磨玻璃影消失。这种磨玻璃影被认为是由于ASD导致肺血流量增加以及蔓状支气管动脉引流至右肺上叶静脉，引起右肺上叶静脉静水压升高，从而导致局部肺淤血。
