肺动静脉畸形在弹簧圈栓塞后因两个弹簧圈迁移至单个病灶并伴有鸟分枝杆菌复合群感染而需要手术切除。
Pulmonary Arteriovenous Malformations Requiring Surgical Resection Due to the Migration of Two Coils into a Single Lesion with Mycobacterium avium Complex Infection after Coil Embolization.
作者信息
Iijima Akinaga, Nakayama Masayuki, Kawahata Toshimi, Saito Mizuho, Kikuchi Tomohiro, Kihara Atsushi, Maemondo Makoto
机构信息
Division of Pulmonary Medicine, Department of Medicine, Jichi Medial University, Japan.
Department of Radiology, School of Medicine, Jichi Medical University, Japan.
出版信息
Intern Med. 2025 Jul 1;64(13):2037-2041. doi: 10.2169/internalmedicine.4227-24. Epub 2024 Dec 12.
A 21-year-old male with hereditary hemorrhagic telangiectasia underwent coil embolization for three pulmonary arteriovenous malformations (right Sc, right Sa, and left Sb). Three years after coil embolization, coil migration was observed in the right Sc and Sa, and a cavitary lesion developed between the two coils. Four years after embolization, the two coil lesions were found to have merged within the cavity. Right lower lobectomy was performed for severe recurrent hemoptysis. A histological examination revealed a granuloma with caseous necrosis related to Mycobacterium avium complex (MAC) infection around the cavity. The patient did not exhibit hemoptysis or MAC recurrence after resection.
一名患有遗传性出血性毛细血管扩张症的21岁男性，因三处肺动静脉畸形（右Sc、右Sa和左Sb）接受了弹簧圈栓塞术。弹簧圈栓塞术后三年，在右Sc和Sa观察到弹簧圈移位，且两个弹簧圈之间出现了空洞性病变。栓塞术后四年，发现两个弹簧圈病变在空洞内融合。因严重反复咯血行右下肺叶切除术。组织学检查显示，空洞周围有与鸟分枝杆菌复合体（MAC）感染相关的干酪样坏死肉芽肿。切除术后患者未出现咯血或MAC复发。
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