Hillen U, Weidenmeier W, Haug C
Abteilung für Pathologie, Universität Ulm.
Dtsch Med Wochenschr. 1991 Nov 29;116(48):1832-6. doi: 10.1055/s-2008-1063826.
An X-ray film of the thorax in a 76-year-old man with recurrent dyspnoea and haemoptysis showed a widened upper mediastinum. Computed tomography demonstrated an aneurysm of an aberrant right subclavian artery as the cause of the symptoms and the mediastinal widening. The patient died 5 days after hospitalization and before a planned operation, another episode of severe haemoptysis having been followed by haematemesis. Autopsy revealed a 13 cm-long aneurysm which had ruptured into the right upper lobe of the lung with bleeding into the bronchial system. No further cases of an aneurysm of an aberrant right subclavian artery with ruptures into the lung parenchyma have been reported so far. But it should be included as a rare cause in the differential diagnosis of recurrent haemoptysis.
一名76岁男性,反复出现呼吸困难和咯血症状,胸部X线片显示上纵隔增宽。计算机断层扫描显示,异常右锁骨下动脉动脉瘤是症状及纵隔增宽的病因。患者在住院5天后,计划手术前死亡,此前出现了另一次严重咯血,随后出现呕血。尸检发现一个13厘米长的动脉瘤,已破裂进入右肺上叶,并向支气管系统出血。迄今为止,尚未有异常右锁骨下动脉动脉瘤破裂进入肺实质的其他病例报道。但在反复咯血的鉴别诊断中,应将其作为一种罕见病因考虑在内。