Massive Hemoptysis of Pulmonary Vein Origin in the Inner Wall of a Lung Abscess.

Hemoptysis of pulmonary vein origin is extremely rare and difficult to manage. A 73-year-old man with a history of chronic heart failure presented with massive hemoptysis. Computed tomography showed an enhancing mass in the upper lobe of the left lung. Bronchial and pulmonary angiograms revealed no feeding vessels. Multidetector row computed tomography angiography showed a pulmonary vein flowing into the lung mass, suggesting that the bleeding had a pulmonary vein origin. Surgical resection of the left upper lobe was then performed. The pathologic diagnosis was lung abscess, with destruction of the pulmonary vein wall observed by elastica van Gieson stain.