Wuest Felix, Gebhardt Andreas, Grosswendt Claudia, Griff Sergej, Zhilina Antonina, Taber Samantha, Kollmeier Jens, Bauer Torsten T
Department of Pneumology, Lungenklinik Heckeshorn, Helios Klinikum Emil von Behring, Walterhoeferstrasse 11 14165 Berlin, Germany.
Institute of Diagnostic and Interventional Radiology, Nuclear Medicine and Molecular Imaging, Helios Klinikum Emil von Behring, Berlin, Germany.
Case Rep Pulmonol. 2023 Jun 16;2023:5553209. doi: 10.1155/2023/5553209. eCollection 2023.
A 68-year-old patient presented with persistent hemoptysis and weight loss. A CT scan showing diffuse bilateral ground-glass opacities and nodules was followed by bronchoscopy. While diffuse alveolar hemorrhage (DAH) could be seen, specimens obtained during bronchoscopy did not provide conclusive histological findings. The decision was made to conduct video-assisted wedge resection, after which histological examinations revealed the diagnosis of bifocal nodular manifestation of an epithelioid angiosarcoma in the lung. Being a rare entity even among sarcomas, these kinds of tumors can be primary lung tissue angiosarcomas or metastatic lesions with primaries in places like the skin, breast, and heart. Treatment usually includes chemotherapy, but prognosis remains grim. This case highlights that in DAH, uncommon causes should be considered, and sufficient probe gathering is the key to early diagnosis and treatment.
一名68岁患者出现持续性咯血和体重减轻。CT扫描显示双侧弥漫性磨玻璃影和结节，随后进行了支气管镜检查。虽然可见弥漫性肺泡出血（DAH），但支气管镜检查获取的标本未提供明确的组织学结果。决定进行电视辅助楔形切除术，术后组织学检查显示诊断为肺上皮样血管肉瘤的双灶结节表现。即使在肉瘤中，这类肿瘤也是罕见的实体，可为原发性肺组织血管肉瘤或皮肤、乳腺和心脏等部位原发性肿瘤的转移灶。治疗通常包括化疗，但预后仍然严峻。该病例强调，在DAH中，应考虑罕见病因，充分采集标本是早期诊断和治疗的关键。
