Abstract
The patient was a 66-year-old woman with bronchial asthma. During a routine follow-up examination, chest X-ray revealed a nodular shadow in the right lower lung field, and she was referred to our hospital for thorough investigation. Computed tomography (CT) scanning of her chest demonstrated a well defined nodular shadow measuring 10×8 mm with a surrounding ground glass-like infiltration shadow extending from S4 to S5 in the right lung. After a one-month follow-up, the shadow showed no tendency of regression, and the possibility of malignant tumor could not be ruled out, either. Consequently, a lung biopsy was performed using a thoracoscope. In thoracoscopy, a dark red nodule with pleural indentation was seen. Intraoperatively, rapid-freeze biopsy revealed moderate infiltration with lymphocytes and thickening of the blood vessel walls, suggesting an old inflammatory lesion. Histopathological examination of the resected lung tissue indicated remarkable thickening of the walls of the pulmonary alveoli and blood vessels, dilatation of the vessels, and hemorrhage inside the alveoli. Accordingly, we diagnosed the lesion as an old hemorrhagic pulmonary infarct. Herein, we report this case of an old hemorrhagic pulmonary infarct that presented radiologically with a nodular shadow and was surgically resected in a woman without underlying diseases except bronchial asthma.
