Xia Dongping, Cao Wenhao, Hu Yi
Department of Respiratory and Critical Care Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Wuhan Clinical Research Center for Interventional Diagnosis and Treatment of Respiratory Diseases, Wuhan, China.
BMC Pulm Med. 2024 Apr 22;24(1):192. doi: 10.1186/s12890-024-02968-0.
Stenosis and obliteration of the pulmonary vein can be developed by multiple diseases and might cause hemoptysis. Traditional therapy including surgical procedure and conservative treatments might be inappropriate choices to manage massive hemoptysis.
A 64-year-old man, diagnosed with advanced stage IVA lung squamous cell carcinoma, presented with dyspnea and recurrent, massive hemoptysis. An initial contrast-enhanced computed tomography revealed a giant tumor in the left lung hilus and occlusion of the left superior pulmonary vein. Despite immediate selective bronchial artery embolization and simultaneous embolization of an anomalous branch of the internal thoracic artery, the massive hemoptysis continued. Subsequently, embolization of the left superior pulmonary artery was performed, achieving functional pulmonary lobectomy, which successfully treated the hemoptysis without relapse during a six-month follow-up. The patient continues to undergo cancer therapy and remains stable.
This case successfully managed massive hemoptysis associated with lung cancer invasion into the pulmonary vein through functional pulmonary lobectomy via embolization of the corresponding pulmonary artery.
多种疾病可导致肺静脉狭窄和闭塞,并可能引起咯血。包括外科手术和保守治疗在内的传统疗法对于处理大量咯血可能并非合适的选择。
一名64岁男性,被诊断为IV A期晚期肺鳞状细胞癌,出现呼吸困难和反复大量咯血。最初的增强计算机断层扫描显示左肺门有一个巨大肿瘤,左肺上静脉闭塞。尽管立即进行了选择性支气管动脉栓塞,并同时栓塞了胸廓内动脉的一个异常分支,但大量咯血仍持续。随后,对左肺上动脉进行了栓塞,实现了功能性肺叶切除,在六个月的随访期间成功治疗了咯血且未复发。该患者继续接受癌症治疗,病情保持稳定。
本病例通过对相应肺动脉进行栓塞实现功能性肺叶切除,成功处理了与肺癌侵犯肺静脉相关的大量咯血。