Department of Surgery, Arrowhead Regional Medical Center, Colton, CA, USA ;
Department of Cardiothoracic Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA ;
Ann Transl Med. 2016 Jun;4(12):242. doi: 10.21037/atm.2016.06.09.
A 57-year-old male presented with progressive exertional dyspnea, cough, and hemoptysis. He underwent a chest computed tomography (CT) that demonstrated a 27 cm × 20 cm right chest mass that was causing a local mass effect. Pertinent history revealed that the patient had suffered a severe chest trauma from a MVA in 1981. The patient underwent workup including: needle localized biopsy, bronchoscopy and endoscopic biopsy. There was considerable concern for a malignant process and a subsequent right pneumonectomy with en bloc resection of the chest wall and diaphragm was performed. The final pathology concluded the mass to be a large pseudoaneurysm. Pseudoaneurysms after traumas are extremely rare, especially blunt trauma, and should be considered once other etiologies have been excluded.
一位 57 岁男性因进行性劳力性呼吸困难、咳嗽和咯血就诊。他接受了胸部计算机断层扫描(CT)检查,结果显示右侧胸部有一个 27cm×20cm 的肿块,导致局部肿块效应。相关病史显示,患者在 1981 年曾遭受过严重的车祸胸部创伤。患者接受了以下检查:针吸活检、支气管镜和内镜活检。高度怀疑为恶性病变,随后进行了右全肺切除术,包括整块切除胸壁和膈肌。最终的病理报告结论为巨大假性动脉瘤。创伤后假性动脉瘤极为罕见,尤其是钝性创伤后,应在排除其他病因后考虑这种情况。