Abstract
Case: A 49-year-old woman visited a local hospital with a complaint of dry cough persisting for the past 3 weeks. A chest radiograph revealed an abnormal shadow in her right lower lung field, she was diagnosed with pneumonia, and started on antibiotic therapy. As the symptoms did not disappear and hemoptysis occurred, she was admitted to our hospital.
As contrast computed tomography (CT) revealed right lower and middle lobe pneumonia, lung abscess, and pulmonary arterial aneurysm in the right pulmonary artery (A8), trans-catheter arterial embolization (TAE) was performed. Hemoptysis disappeared temporarily, but massive hemoptysis occurred again five days after embolization. Bronchial artery angiography was performed, but the pulmonary arterial aneurysm could not be visualized. Contrast-enhanced CT revealed the enlargement of the aneurysm. Therefore, it was judged that the embolization had been ineffective, so right lower and middle bi-lobectomy was performed.
Pathologically, the patient was diagnosed with a pulmonary artery pseudoaneurysm. She was discharged on the 11th day after surgery without any complications, and her condition was favorable as of the two-year follow-up.
Conclusion: Surgical treatment should be considered for cases of pulmonary artery aneurysm, in which hemoptysis occurs again after TAE, the effect of TAE is deemed insufficient, and the general condition is unstable.
