Baylor Scott and White Central Texas, Temple, Texas, USA
Pulmonary & Critical Care, Baylor Scott and White Central Texas, Temple, Texas, USA.
BMJ Case Rep. 2021 Mar 9;14(3):e241225. doi: 10.1136/bcr-2020-241225.
A 35-year-old man was admitted to the intensive care unit with massive haemoptysis. CT of the chest revealed a necrotic right upper lobe mass. Angiography of his thoracic vasculature revealed a pseudoaneurysm in the right subclavian artery with active contrast extravasation. This anatomic deformity was stented and coiled with the assistance of interventional radiology. Bronchoscopy with lavage and brushings of the right upper lobe mass revealed fungal hyphae and positive galactomannan, supporting that the patient developed invasive pulmonary aspergillosis leading to a mycotic pseudoaneurysm of the right subclavian artery followed by massive haemoptysis.
一名 35 岁男性因大咯血被收入重症监护病房。胸部 CT 显示右肺上叶坏死性肿块。胸部血管造影显示右锁骨下动脉假性动脉瘤伴造影剂外渗。在介入放射学的协助下，对该解剖畸形进行了支架和线圈栓塞。对右上肺肿块进行支气管镜检查、灌洗和刷检，发现真菌菌丝和阳性半乳甘露聚糖，支持该患者发生侵袭性肺曲霉病，导致右锁骨下动脉真菌性假性动脉瘤，继而发生大咯血。
