Matsutani Noriyuki, Dejima Hitoshi, Takahashi Yusuke, Uehara Hirofumi, Iinuma Hisae, Tanaka Fumihiko, Kawamura Masafumi
Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
Department of Pathology, Teikyo University School of Medicine, Tokyo, Japan.
J Thorac Dis. 2016 Oct;8(10):E1187-E1189. doi: 10.21037/jtd.2016.09.68.
A 25-year-old male with Birt-Hogg-Dube (BHD) syndrome who developed hemothorax caused by ruptured of pulmonary arteriovenous malformation was reported. The patient was admitted to the hospital due to chest pain. A chest X-ray showed pleural fluid in his left lung, and a chest CT showed the presence of a tumor with enhanced contrast in the lower left lobe of approximately 5 cm in a diameter. Pleural fluid was collected by tap and indicated the presence of blood; therefore, hemothorax was suspected. Thoracoscopic surgery was performed to remove the mass for homostasis. Pathological findings indicated that the resected tumor-like lesion was an intrapulmonary hematoma, and aggregated vascular vessels of various diameters forming incomplete media elastic lamina was observed around the hematoma; therefore, it was diagnosed as pulmonary arteriovenous malformation. Family history of the patient indicated the presence of pneumothorax and malignant diseases, and the patient presented with papules and multiple pulmonary cysts. The genetic test revealed a deletion of exon 11 of the gene; therefore, the patient was diagnosed with BHD syndrome. This report is the first to describe BHD syndrome accompanied by pulmonary arteriovenous malformation.
报告了一名25岁患有Birt-Hogg-Dube(BHD)综合征的男性,其因肺动静脉畸形破裂导致血胸。该患者因胸痛入院。胸部X线显示左肺有胸腔积液,胸部CT显示左下叶有一个直径约5 cm的增强造影肿瘤。通过穿刺收集胸腔积液,提示有血液存在;因此,怀疑为血胸。进行胸腔镜手术切除肿块以止血。病理结果表明,切除的肿瘤样病变为肺内血肿,在血肿周围观察到聚集的不同直径血管形成不完整的中膜弹性层;因此,诊断为肺动静脉畸形。患者家族史显示有气胸和恶性疾病,且患者有丘疹和多个肺囊肿。基因检测显示该基因第11外显子缺失;因此,该患者被诊断为BHD综合征。本报告首次描述了伴有肺动静脉畸形的BHD综合征。