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毛霉菌病所致肺动脉假性动脉瘤:病例报告及文献复习

Pulmonary Artery Pseudoaneurysm due to Mucormycosis: Case Report and Literature Review.

作者信息

Mempin Roberto, Kamangar Nader

机构信息

Division of Pulmonary and Critical Care Medicine, Olive View-UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California, United States.

出版信息

J Clin Imaging Sci. 2020 Sep 3;10:55. doi: 10.25259/JCIS_127_2020. eCollection 2020.

Abstract

Pulmonary artery pseudoaneurysm (PAP) is a rare vascular phenomenon with a high mortality rate, as these entities can enlarge, rupture, and lead to asphyxiation. Pulmonary mucormycosis (PM), an underdiagnosed but an increasingly seen entity in the era of chemotherapy and immunosuppression, is a known cause of PAP, and should be suspected in immunosuppressed patients with hemoptysis. We present a case of PAP due to PM in a patient with recently diagnosed diffuse large B-cell lymphoma of the liver who underwent chemotherapy and developed acute cavitary lung disease and hemoptysis. His diagnosis was delayed due to the withholding of iodinated contrast with computer tomography (CT) imaging in the setting of renal failure. He then underwent embolization of his PAP with resolution of his hemoptysis. PAP is an uncommon cause of hemoptysis that can be diagnosed with CT pulmonary angiography, and mucormycosis is a known but rare cause of PAP in patients with malignancy receiving immunosuppression.

摘要

肺动脉假性动脉瘤(PAP)是一种罕见的血管现象,死亡率很高,因为这些病变会扩大、破裂并导致窒息。肺毛霉菌病(PM)在化疗和免疫抑制时代是一种诊断不足但越来越常见的疾病,是PAP的已知病因,对于咯血的免疫抑制患者应怀疑此病。我们报告一例因PM导致PAP的病例,该患者最近被诊断为肝脏弥漫性大B细胞淋巴瘤,接受化疗后出现急性空洞性肺病和咯血。由于在肾衰竭情况下计算机断层扫描(CT)成像未使用碘化造影剂,其诊断被延迟。随后他接受了PAP栓塞术,咯血症状得以缓解。PAP是咯血的罕见病因,可通过CT肺动脉造影诊断,毛霉菌病是接受免疫抑制的恶性肿瘤患者发生PAP的已知但罕见的病因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fba/7533101/7f0915c6764e/JCIS-10-55-g001.jpg

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