Castro Horacio Matias, Wainstein Esteban Javier
Hospital Italiano de Buenos Aires.
Rev Fac Cien Med Univ Nac Cordoba. 2018 Nov 13;75(4):288-291. doi: 10.31053/1853.0605.v75.n3.17934.
Pulmonary vein stenosis is an infrequent complication of catheter ablation of atrial fibrillation. Its incidence varies widely from 0.3% to 6% according to different publications. The clinical presentation raises suspicion of more common pathologies. We present a case of pulmonary vein stenosis following catheter ablation of atrial fibrillation that resembled -clinically and on radiology- a lung neoplasm. We report a case of a 57-years-old male current smoker who developed pulmonary vein stenosis following catheter ablation of atrial fibrillation. The clinical (cough and hemoptysis), radiological (Positron-Emission Tomography positive pulmonary nodules) and bronchoscopy (edematous mucosa) were consistent with a lung neoplasm. Although previous cases of pulmonary vein stenosis resembling lung cancer have been published, we are unaware of previous description of pulmonary vein stenosis as cause of Positron-Emission Tomography positive pulmonary nodules. The case highlights the importance of considering pulmonary vein stenosis as a cause of cough, dyspnea and hemoptysis in patient with previous catheter ablation of atrial fibrillation in order to prevent unnecessary -often invasive- studies.
肺静脉狭窄是心房颤动导管消融术的一种罕见并发症。根据不同的文献报道，其发生率差异很大，从0.3%到6%不等。临床表现常使人怀疑是更常见的疾病。我们报告一例心房颤动导管消融术后发生肺静脉狭窄的病例，该病例在临床和影像学上类似于肺部肿瘤。我们报道了一名57岁男性现吸烟者，在心房颤动导管消融术后发生了肺静脉狭窄。临床症状（咳嗽和咯血）、影像学表现（正电子发射断层扫描显示肺部有阳性结节）和支气管镜检查（黏膜水肿）均与肺部肿瘤相符。虽然之前已经发表过一些肺静脉狭窄类似肺癌的病例，但我们尚未发现将肺静脉狭窄作为正电子发射断层扫描显示肺部阳性结节原因的相关描述。该病例强调了对于有过心房颤动导管消融术的患者，在出现咳嗽、呼吸困难和咯血时，应考虑肺静脉狭窄作为病因，以避免不必要的（通常是侵入性的）检查。
