Akiyama Y, Takeda Y, Soma T, Sato T, Kamimura M, Suzuki N, Kawada H, Suzuki T, Kudo K
Department of Pulmonary Medicine, International Medical Center of Japan, Tokyo, Japan.
Nihon Kokyuki Gakkai Zasshi. 1998 May;36(5):488-93.
A 53-year-old woman was admitted to the hospital for investigation of an abnormal shadow in the middle lobe of the right lung on a chest X-ray film. The filling of most of the shadowed area with contrast media on a chest CT scan suggested a vascular lesion. Further investigation by intravenous digital subtraction angiography and color doppler sonography led to the diagnosis of pulmonary arteriovenous malformation. An abdominal CT scan suggested the presence of an arteriovenous malformation in the liver, and a bronchoscopic study revealed telangiectatic lesions on the laryngeal mucosa. The patient's father had died at the age of 61, due to intracranial bleeding, which suggested he might have had an arteriovenous malformation in the brain. The patient's daughter has a pulmonary arteriovenous malformation. This family of vascular malformation indicates that the patient had Osler-Weber-Rendu disease. Osler-Weber-Rendu disease is an autosomal-dominant inherited disorder that may give rise to arteriovenous malformations, mainly in the lungs and the brain. We found that color doppler sonography can be useful for the diagnosis of pleural-based pulmonary arteriovenous malformation.
一名53岁女性因胸部X光片显示右肺中叶异常阴影而入院检查。胸部CT扫描显示大部分阴影区域有造影剂充盈,提示为血管病变。通过静脉数字减影血管造影和彩色多普勒超声进一步检查,诊断为肺动静脉畸形。腹部CT扫描提示肝脏存在动静脉畸形,支气管镜检查发现喉黏膜有毛细血管扩张性病变。患者的父亲61岁时死于颅内出血,提示他可能脑部有动静脉畸形。患者的女儿有肺动静脉畸形。这个血管畸形家族表明该患者患有遗传性出血性毛细血管扩张症。遗传性出血性毛细血管扩张症是一种常染色体显性遗传性疾病,可导致动静脉畸形,主要发生在肺部和脑部。我们发现彩色多普勒超声对基于胸膜的肺动静脉畸形的诊断很有用。