Campos Leticia Goulart, da Silva Eveline Cristina, Rangel Ana Fernanda Ribeiro, de Souza Marina Dias, Musso Carlos
Federal University of Espírito Santo (UFES), Department of Pathology, Hospital Universitário Cassiano Antônio Moraes (HUCAM), Unidade de Anatomia Patológica. Vitória, ES, Brazil.
Autops Case Rep. 2019 Dec 13;10(1):e2019131. doi: 10.4322/acr.2019.131. eCollection 2020 Jan-Mar.
Pulmonary artery aneurysm is a disorder of varying etiology and should be diagnosed early for appropriate interventions. A 45-year-old man was hospitalized for chest pain, dyspnea, cough, chills, diarrhea, and vomiting, which had started 3 weeks before admission. Physical examination indicated a reduced vesicular murmur in the right hemithorax. A chest x-ray performed indicated a pneumothorax and pulmonary abscess in the right hemithorax. Thoracostomy released abundant purulent and fetid fluid. Direct examination of the pleural fluid using saline revealed structures similar to . Non-contrast chest computed tomography revealed right pneumothorax along with an irregular cavitation located at the pleuropulmonary interface of the posterior margin of the right lower lobe. A pleurostomy was performed. On the second postoperative day, the patient suffered a sudden major hemorrhage through the surgical wound and died on the way to the operating room. The autopsy revealed an abscess and ruptured aneurysm of the lower lobar artery in the lower right lung. Microscopic examination revealed extensive liquefactive necrosis associated with purulent inflammation and the presence of filamentous fungi and spores. This case can be characterized as a severe disorder that requires early diagnosis to achieve a good therapeutic response and to avoid fatal outcomes.
肺动脉瘤是一种病因各异的病症，应尽早诊断以便进行适当干预。一名45岁男性因胸痛、呼吸困难、咳嗽、寒战、腹泻和呕吐入院，这些症状在入院前3周就已出现。体格检查显示右半侧胸廓的肺泡呼吸音减弱。胸部X光检查显示右半侧胸廓有气胸和肺脓肿。胸腔造口术引出了大量脓性且有恶臭的液体。用生理盐水直接检查胸腔积液发现了类似……的结构。胸部非增强计算机断层扫描显示右气胸，同时在右下叶后缘的胸膜肺界面处有一个不规则空洞。进行了胸膜造口术。术后第二天，患者通过手术伤口突然发生大出血，在送往手术室的途中死亡。尸检发现右下肺下叶动脉有脓肿和动脉瘤破裂。显微镜检查显示广泛的液化性坏死，伴有脓性炎症以及丝状真菌和孢子的存在。该病例可被视为一种严重病症，需要早期诊断以获得良好的治疗效果并避免致命后果。
