Hui Cathryn
Department of Radiology, Faculty of Medicine, Vancouver General Hospital, Vancouver, BC, Canada.
Clin Respir J. 2008 Jul;2(3):183-6. doi: 10.1111/j.1752-699X.2008.00061.x.
Diffuse pulmonary haemorrhage is a potentially life-threatening complication of a variety of conditions. Tumours, including angiosarcoma lung metastases, are an unusual cause of pulmonary haemorrhage.
Report of a case.
This case describes a 38-year-old previously healthy male who presented with chest wall bruising followed by haemoptysis and a cerebellar haemorrhage. The patient developed diffuse pulmonary haemorrhage. A biopsy of the chest wall lesion indicated a haematoma and an open-lung biopsy suggested the diagnosis of vasculitis. The patient died within 3 months after initial presentation and an autopsy revealed a chest wall angiosarcoma with pulmonary and cerebellar metastases.
Pulmonary angiosarcoma metastases should be included in the differential diagnosis of diffuse pulmonary haemorrhage, especially in a young, previously healthy patient with normal renal function, particularly as the pathological diagnosis may be difficult and even misleading.
弥漫性肺出血是多种疾病潜在的危及生命的并发症。肿瘤,包括血管肉瘤肺转移,是肺出血的不常见原因。
病例报告。
本病例描述了一名38岁既往健康的男性,最初表现为胸壁瘀伤,随后出现咯血和小脑出血。患者发生了弥漫性肺出血。胸壁病变活检显示为血肿,开胸肺活检提示血管炎诊断。患者在初次就诊后3个月内死亡,尸检发现胸壁血管肉瘤伴肺和小脑转移。
肺血管肉瘤转移应纳入弥漫性肺出血的鉴别诊断,尤其是在年轻、既往健康且肾功能正常的患者中,特别是因为病理诊断可能困难甚至具有误导性。