Minamikawa Risako, Ryu Yasuji, Sanada Junichiro, Takata Harumi, Okumura Toshiya
Department of Radiology, Tonami General Hospital, 1-61 Shintomicho, Tonami City, Toyama Prefecture 939-1395, Japan.
Department of Radiology, Ageo Central General Hospital, Ageo City, Saitama Prefecture, Japan.
Radiol Case Rep. 2020 Dec 1;16(2):305-308. doi: 10.1016/j.radcr.2020.11.037. eCollection 2021 Feb.
There have been few reports of pulmonary arteriovenous malformations complicated by hemoptysis. Herein, we present our experience and provided a review of the literature. A man in his 80s came to our hospital with a chief complaint of hemoptysis, and a simple computed tomography showed a consolidation in the right lower lobe of the lung. He was treated for bacterial pneumonia, and his symptoms and a consolidation resolved, but similar episodes continued afterwards. About 18 months after the initial disease onset, the patient had hemoptysis and came to our hospital again. He was diagnosed with pulmonary arteriovenous malformation due to the presence of a lumpy, mass-like dilatation in the peripheral arteries. With the suspicion that the hemoptysis was caused by pulmonary arteriovenous malformations, the patient underwent coil embolization, and his symptoms gradually resolved. Computed tomography also showed improvement in shadowing. The hidden arteriovenous malformation was buried by a dense pulmonary field shadow; thus, it was diagnosed after a long time. This case highlights that pulmonary arteriovenous malformations should be considered in differentiating cases presenting with hemoptysis.
关于肺动静脉畸形并发咯血的报道很少。在此，我们介绍我们的经验并对文献进行综述。一名80多岁的男性因咯血为主诉前来我院，胸部单纯计算机断层扫描显示右下肺有实变。他接受了细菌性肺炎的治疗，症状和实变消失，但此后类似发作仍有持续。在最初发病约18个月后，患者再次因咯血前来我院。由于外周动脉存在结节状、团块状扩张，他被诊断为肺动静脉畸形。鉴于怀疑咯血是由肺动静脉畸形引起，患者接受了弹簧圈栓塞治疗，症状逐渐缓解。计算机断层扫描也显示阴影有所改善。隐匿的动静脉畸形被致密的肺野阴影掩盖，因此经过很长时间才得以诊断。该病例强调，在鉴别咯血病例时应考虑肺动静脉畸形。
