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Erschienen in: Journal of Medical Case Reports 1/2017

Open Access 01.12.2017 | Case report

Bilateral multiple pulmonary artery aneurysms associated with cavitary pulmonary tuberculosis: a case report

verfasst von: Pedro Pallangyo, Frederick Lyimo, Smita Bhalia, Hilda Makungu, Bashir Nyangasa, Flora Lwakatare, Pal Suranyi, Mohamed Janabi

Erschienen in: Journal of Medical Case Reports | Ausgabe 1/2017

Abstract

Background

Pulmonary artery aneurysms constitute <1% of aneurysms occurring in the thoracic cavity. Congenital cardiac defects are responsible for the majority (>50%) of cases, however, pulmonary artery aneurysm is a rare sequelae of pulmonary tuberculosis reported in about 5% of patients with chronic cavitary tuberculosis on autopsy. The natural history of this potentially fatal condition remains poorly understood and guidelines for optimal management are controversial.

Case presentation

A 24-year-old man, a nursing student of African descent, was referred to us from an up-country regional hospital with a 4-week history of recurrent episodes of breathlessness, awareness of heartbeats and coughing blood 3 weeks after completing a 6-month course of anti-tuberculosis drugs. A physical examination revealed conjuctival and palmar pallor but there were no stigmata of connective tissue disorders, systemic vasculitides or congenital heart disease. An examination of the cardiovascular system revealed accentuated second heart sound (S2) with early diastolic (grade 1/6) and holosystolic (grade 2/6) murmurs at the pulmonic and tricuspid areas respectively. Blood tests showed iron deficiency anemia, prolonged bleeding time, and mild hyponatremia. A chest radiograph revealed bilateral ovoid-shaped perihilar opacities while a computed tomography scan showed bilateral multiple pulmonary artery pseudoaneurysms with surrounding hematoma together with adjacent cystic changes, consolidations, and tree-in-bud appearance. Our patient refused to undergo surgery and died of aneurismal rupture after 9 days of hospitalization.

Conclusions

The presence of intractable hemoptysis among patients with tuberculosis even after completion of anti-tuberculosis course should raise an index of suspicion for pulmonary artery aneurysm. Furthermore, despite of its rarity, early recognition and timely surgical intervention of pulmonary artery aneurysm is crucial to reducing morbidity and preventing the attributed mortality.
Abkürzungen
CT
Computed tomography
ECG
Electrocardiogram
ECHO
Echocardiography
Hb
Hemoglobin
IVDU
Intravenous drug use
MCH
Mean corpuscular hemoglobin
MCV
Mean corpuscular volume
MRI
Magnetic resonance imaging
Na+
Sodium concentration
PAA
Pulmonary artery aneurysm
PT
Prothrombin time
PTT
Partial thromboplastin time
RDW
Red cell distribution width
RVSP
Right ventricular systolic pressure
STI
Sexually transmitted infections
TB
Tuberculosis

Background

Focal dilatation (>4 cm) [13] of the pulmonary arterial system is referred to as pulmonary artery aneurysm (PAA). Owing to its asymptomatic course in the majority of cases, this rare entity used to be an autopsy finding with prevalence rates ranging between 0.001% and 0.007% [47]. With the advent of a two-dimensional (2D)-echocardiography (ECHO), computed tomography (CT) scan and magnetic resonance imaging (MRI), more cases are now diagnosed often incidentally among living patients [813]. Nonetheless, the natural history of this potentially fatal condition remains poorly understood and guidelines for optimal management are controversial [3, 1418].
Causes of PAA are numerous and diverse in pathogenesis, however, congenital cardiac defects (patent ductus arteriosus, ventricular and atrial septal defects) are implicated in about 50% of cases [19, 20]. Other causes include infections (tuberculosis, syphilis, mycotic aneurysms), systemic vasculitides (Behcet’s disease, giant cell arteritis), connective tissue disorders (Marfan’s syndrome, Hughes-Stovin syndrome), degenerative diseases (atherosclerosis), chest trauma, and idiopathic PAA [3, 4, 8, 9, 14, 1624]. The clinical manifestations of PAA are largely nonspecific but dyspnea, palpitations, chest pain, cough, and hemoptysis are frequently reported in symptomatic patients [128]. Radiological imaging is essential in establishing the diagnosis as the nonspecific clinical findings are inevitably inconclusive. We report a case of bilateral multiple pulmonary artery aneurysms in a 24-year-old male nursing student from Tanzania.

Case presentation

A 24-year-old man, a nursing student of African descent, was referred to us from an up-country regional hospital for further investigations and expert management. His past medical history was unremarkable and he denied any history of tobacco or intravenous drug use (IVDU), chest trauma, sexually transmitted infection (STI) or open tuberculosis (TB) contact. He was diagnosed with pulmonary TB based on constitutional symptoms and chest X-ray findings, and had completed a 6-month course of anti-TB medications (isoniazid, rifampicin, pyrazinamide, and ethambutol) 7 weeks prior his visit to our institution. He was somewhat symptom-free for about 3 weeks when he developed recurrent episodes of breathlessness, awareness of heartbeats and coughing blood, which had gradually worsened and persisted for about 4 weeks prior this index visit.
On examination, he was a sick-looking but oriented and well-kempt young man. He had a blood pressure of 92/57 mmHg, pulse rate of 121 beats/minute, respiratory rate of 19 breaths/minute and temperature of 36.7 °C. His body mass index (BMI) was 21.2 kg/m2 (weight 59 kg and height 1.67 m). A physical examination revealed conjuctival and palmar pallor but there were no stigmata of connective tissue disorders, systemic vasculitides or congenital heart disease. A respiratory system examination revealed bilateral symmetrical chest movements; however, dullness and reduced breath sounds were noted on the mammary and inframammary regions bilaterally on percussion and auscultation respectively. An examination of the cardiovascular system revealed accentuated second heart sound (S2) with early diastolic (grade 1/6) and holosystolic (grade 2/6) murmurs at the pulmonic and tricuspid areas respectively.
Hematological and biochemical tests revealed iron deficiency anemia [hemoglobin (Hb) 8.18 g/dL, mean corpuscular volume (MCV) 61.8 fL, mean corpuscular hemoglobin (MCH) 19.2 pg/cell and red cell distribution width (RDW) 21.9%], prolonged bleeding time [prothrombin time (PT) 14.6 s and partial thromboplastin time (PTT) 32.7 s], and mild hyponatremia [sodium concentration (Na+) 132 mmol/L]. Serological tests for human immunodeficiency virus (HIV), hepatitis B and C, and syphilis were all negative. Moreover, occult blood test was negative and an abdominal ultrasonography scan was unremarkable. A sputum culture revealed Pseudomonas aeruginosa 3++ sensitive to ciprofloxacin and gentamicin. A chest X-ray showed bilateral, ovoid-shaped perihilar opacities extending to lower lung zones with loss of silhouette sign on the left cardiac border (Fig. 1). An electrocardiogram (ECG) displayed a sinus tachycardia while echocardiography (ECHO) was evident for right ventricular hypertrophy, mild tricuspid regurgitation with estimated right ventricular systolic pressure (RVSP) of 29 mmHg (that is, mild pulmonary hypertension) and multiple focal dilatations along the right and left pulmonary arteries. Systolic functions were, however, preserved (ejection fraction 53%). A GeneXpert test was positive. A computed tomography (CT) scan of his chest showed bilateral multiple pulmonary artery pseudoaneurysms with surrounding hematoma together with adjacent cystic changes, consolidations and tree-in-bud appearance (Figs. 2, 3, 4, and 5). The aneurysms on the right pulmonary artery measured 3.81×2.55 cm and 6.96×5.34 cm whereas those on the left measured 2.61×2.03 cm, 6.85×4.45 cm and 7.05×4.03 cm respectively. His main pulmonary artery (2.55 cm), ascending (2.28 cm), arch (1.89 cm), and descending aorta (2.00 cm) had normal caliber and dimensions. We entertained a diagnosis of bilateral multiple pulmonary pseudoaneurysms associated with cavitary pulmonary tuberculosis and admitted him to the general medical ward. Intravenous ciprofloxacin 500 mg 12 hourly, bisoprolol 5 mg once daily, tadalafil (40 mg) and ferrous sulfate (270 mg) plus folic acid (300 mcg) were initiated. Moreover, our patient was counseled regarding surgery and prognosis of his condition; however, he refused to undergo any surgical procedure. After 9 days of hospitalization, our patient died of aneurismal rupture. Due to religious beliefs, relatives of the deceased refused an autopsy and one was not done.

Discussion

Pulmonary artery aneurysms constitute <1% of aneurysms occurring in the thoracic cavity [29]. The cause could be idiopathic but many medical conditions including congenital heart defects, connective tissue disorders, systemic vasculitides, and infections are often associated with PAA [3, 4, 8, 9, 14, 1624]. Clinical presentation is invariably nonspecific and roughly depends on the underlying etiology, location, and size of the aneurysm [9]. Owing to its largely vague presentation [47], noninvasive imaging techniques are crucial in reaching the diagnosis [813]; however, pulmonary angiography remains the gold standard diagnostic modality [2, 8, 19, 21, 23, 3032]. About 20–60% of patients with PAA will die from aneurysm rupture while other serious complications including airway compression and intravascular thrombosis are not uncommon [9, 3338].
Hemoptysis in a tuberculosis (TB) setting is relatively common, usually self-limiting or controlled by anti-TB drugs. Nevertheless, presence of a massive or several episodes of minor hemoptysis in TB is life-threatening, likely originating from the arterial system, and require early and aggressive intervention [39, 40]. Rasmussen’s aneurysm is a rare sequalae of pulmonary TB resulting from gradual weakening of the pulmonary artery wall from the adjacent tubercular cavity leading to thinning and pseudoaneurysm formation [3639]. It has been reported in approximately 5% of autopsy series involving patients with chronic cavitary tuberculosis [3944]. Despite absence of clear guidelines for treatment of PAA, several surgical techniques including aneurysmorrhaphy, Dacron graft replacement, pulmonary allograft replacement, and replacement with combination of Dacron prosthesis and stentless bioprosthesis are advocated [9, 19, 21, 28, 45, 46]. Furthermore, patients presenting with massive hemoptysis are usually treated with a bronchial artery embolization procedure [47]. However, such an embolization procedure technique requires special care especially in pseudoaneurysms as they are easily prone to rupture with resultant fatal bleeding [39, 43, 47].
Our patient refused to undergo any surgical procedure and consequently died of aneurismal rupture on the ninth day of hospitalization. Arguably, even if he had opted for surgery, the presence of multiple bilateral large pseudoaneurysms would have potentiated a high risk of fatal bleeding, among other complications, using any surgical technique. Nevertheless, watchful waiting, as in this case, portends a very poor prognosis. To the best of our knowledge, this was the first ever case of TB-associated PAA to be diagnosed and documented in Tanzania. We hope that upon its publication this case will sensitize practitioners to consider and assess for PAA whenever faced by hemoptysis not responding to otherwise routine therapy.

Conclusions

In conclusion, presence of intractable hemoptysis among TB patients even after completion of an anti-TB course should raise an index of suspicion for PAA. Furthermore, despite its rarity, early recognition and timely surgical intervention is crucial in reducing morbidity and preventing the attributed mortality.

Acknowledgements

The authors are grateful to the staff of the Jakaya Kikwete Cardiac Institute and Muhimbili National Hospital for their hard work and cooperation in daily patient management.

Funding

Not applicable

Availability of data and materials

Not applicable
Ethical clearance was granted by the Directorate of Research of the Jakaya Kikwete Cardiac Institute
Written informed consent was obtained from the patient’s next-of-kin for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

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Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://​creativecommons.​org/​licenses/​by/​4.​0/​), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://​creativecommons.​org/​publicdomain/​zero/​1.​0/​) applies to the data made available in this article, unless otherwise stated.

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Literatur
1.
Zurück zum Zitat Barbour DJ, Roberts WC. Aneurysm of the pulmonary trunk unassociated with intracardiac or great vessel left-to-right shunting. Am J Cardiol. 1987;59:192–4.CrossRefPubMed Barbour DJ, Roberts WC. Aneurysm of the pulmonary trunk unassociated with intracardiac or great vessel left-to-right shunting. Am J Cardiol. 1987;59:192–4.CrossRefPubMed
2.
Zurück zum Zitat Chetty KG, McGovern J, Mahutte CK. Hilar mass in a patient with chest pain. Chest. 1996;109(6):1643–4.CrossRefPubMed Chetty KG, McGovern J, Mahutte CK. Hilar mass in a patient with chest pain. Chest. 1996;109(6):1643–4.CrossRefPubMed
3.
Zurück zum Zitat Araújo I, Escribano P, Lopez-Gude MJ, et al. Giant pulmonary artery aneurysm in a patient with vasoreactive pulmonary hypertension: a case report. BMC Cardiovasc Disord. 2011;11:64.CrossRefPubMedPubMedCentral Araújo I, Escribano P, Lopez-Gude MJ, et al. Giant pulmonary artery aneurysm in a patient with vasoreactive pulmonary hypertension: a case report. BMC Cardiovasc Disord. 2011;11:64.CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Serasli E, Antoniadou M, Steiropoulos P, et al. Low-pressure pulmonary artery aneurysm presenting with pulmonary embolism: a case series. J Med Case Rep. 2011;5:163.CrossRefPubMedPubMedCentral Serasli E, Antoniadou M, Steiropoulos P, et al. Low-pressure pulmonary artery aneurysm presenting with pulmonary embolism: a case series. J Med Case Rep. 2011;5:163.CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Seguchi M, Wada H, Sakakura K, et al. Idiopathic pulmonary artery aneurysm. Circulation. 2011;124(14):369–70.CrossRef Seguchi M, Wada H, Sakakura K, et al. Idiopathic pulmonary artery aneurysm. Circulation. 2011;124(14):369–70.CrossRef
6.
Zurück zum Zitat Ting P, Jugdutt BI, Le Tan J. Large pulmonary artery aneurysm associated with Marfan syndrome. Int J Angiol. 2012;19(1):48–50.CrossRef Ting P, Jugdutt BI, Le Tan J. Large pulmonary artery aneurysm associated with Marfan syndrome. Int J Angiol. 2012;19(1):48–50.CrossRef
7.
Zurück zum Zitat Deterling Jr RA, Clagett T. Aneurysm of the pulmonary artery; review of the literature and report of a case. Am Heart J. 1947;34:471–99.CrossRefPubMed Deterling Jr RA, Clagett T. Aneurysm of the pulmonary artery; review of the literature and report of a case. Am Heart J. 1947;34:471–99.CrossRefPubMed
8.
Zurück zum Zitat Nguyen ET, Silva CIS, Seely JM, Chong S, Lee KS, Müller NL. Pulmonary artery aneurysms and pseudoaneurysms in adults: findings at CT and radiography. AJR. 2007;188(2):126–34.CrossRef Nguyen ET, Silva CIS, Seely JM, Chong S, Lee KS, Müller NL. Pulmonary artery aneurysms and pseudoaneurysms in adults: findings at CT and radiography. AJR. 2007;188(2):126–34.CrossRef
9.
Zurück zum Zitat Sargur R, Murthy KAS. Pulmonary artery aneurysm - report of a case and review of literature. J Cardiovasc Med Cardiol. 2015;2(1):29–31. Sargur R, Murthy KAS. Pulmonary artery aneurysm - report of a case and review of literature. J Cardiovasc Med Cardiol. 2015;2(1):29–31.
10.
Zurück zum Zitat Wu WS. Images in cardiovascular medicine. Huge calcified pulmonary arterial aneurysm. Circulation. 2003;107:2280–1.CrossRefPubMed Wu WS. Images in cardiovascular medicine. Huge calcified pulmonary arterial aneurysm. Circulation. 2003;107:2280–1.CrossRefPubMed
11.
Zurück zum Zitat Janssens F, Verswijvel G, Colla P, Smits J, Gubbelmans H, et al. Proximal pulmonary artery aneurysm. JBR-BTR. 2003;86:83–5.PubMed Janssens F, Verswijvel G, Colla P, Smits J, Gubbelmans H, et al. Proximal pulmonary artery aneurysm. JBR-BTR. 2003;86:83–5.PubMed
12.
Zurück zum Zitat Khalil A, Parrot A, Fartoukh M, et al. Images in cardiovascular medicine. Large pulmonary artery aneurysm rupture in Hughes-Stovin syndrome: multidetector computed tomography pattern and endovascular treatment. Circulation. 2006;114:380–1.CrossRef Khalil A, Parrot A, Fartoukh M, et al. Images in cardiovascular medicine. Large pulmonary artery aneurysm rupture in Hughes-Stovin syndrome: multidetector computed tomography pattern and endovascular treatment. Circulation. 2006;114:380–1.CrossRef
13.
Zurück zum Zitat Cherwek H, Amundson S. Images in clinical medicine. Pulmonary-artery aneurysm. N Engl J Med. 2003;348:e1.CrossRefPubMed Cherwek H, Amundson S. Images in clinical medicine. Pulmonary-artery aneurysm. N Engl J Med. 2003;348:e1.CrossRefPubMed
14.
Zurück zum Zitat Singh V, Khare R, Chandra S, Dwivedi SK. Giant pulmonary artery aneurysm in a patient with rheumatic mitral stenosis. Heart Views. 2014;15:89–92.CrossRefPubMedPubMedCentral Singh V, Khare R, Chandra S, Dwivedi SK. Giant pulmonary artery aneurysm in a patient with rheumatic mitral stenosis. Heart Views. 2014;15:89–92.CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Mayoral-Campos V, de Benito-Arévalo JL, Varea-Sanz MA. Pulmonary artery aneurysm. Arch Bronconeumol. 2013;49:551–2.PubMed Mayoral-Campos V, de Benito-Arévalo JL, Varea-Sanz MA. Pulmonary artery aneurysm. Arch Bronconeumol. 2013;49:551–2.PubMed
16.
Zurück zum Zitat Baztarrica GP, Bevacqua F, Porcile R. Pulmonary artery aneurysm. Rev Esp Cardiol. 2010;63:240–1.CrossRefPubMed Baztarrica GP, Bevacqua F, Porcile R. Pulmonary artery aneurysm. Rev Esp Cardiol. 2010;63:240–1.CrossRefPubMed
17.
Zurück zum Zitat Vistarini N, Aubert S, Gandjbakhch I, Pavie A. Surgical treatment of a pulmonary artery aneurysm. Eur J Cardiothorac Surg. 2007;31(6):1139–41.CrossRefPubMed Vistarini N, Aubert S, Gandjbakhch I, Pavie A. Surgical treatment of a pulmonary artery aneurysm. Eur J Cardiothorac Surg. 2007;31(6):1139–41.CrossRefPubMed
18.
Zurück zum Zitat Garcia A, Byrne JG, Bueno R, et al. Aneurysm of the main pulmonary artery. Ann Thorac Cardiovasc Surg. 2008;14:399–401.PubMed Garcia A, Byrne JG, Bueno R, et al. Aneurysm of the main pulmonary artery. Ann Thorac Cardiovasc Surg. 2008;14:399–401.PubMed
19.
Zurück zum Zitat Shih HH, Kang PL, Lin CY, Lin YH. Main pulmonary artery aneurysm. J Chin Med Assoc. 2007;70(10):453–5.CrossRefPubMed Shih HH, Kang PL, Lin CY, Lin YH. Main pulmonary artery aneurysm. J Chin Med Assoc. 2007;70(10):453–5.CrossRefPubMed
20.
Zurück zum Zitat Shankarappa RK, Moorthy N, Chandrasekaran D, Nanjappa MC. Giant pulmonary artery aneurysm secondary to primary pulmonary hypertension. Tex Heart Ins J. 2010;37:244–5. Shankarappa RK, Moorthy N, Chandrasekaran D, Nanjappa MC. Giant pulmonary artery aneurysm secondary to primary pulmonary hypertension. Tex Heart Ins J. 2010;37:244–5.
21.
Zurück zum Zitat Fazlinejad A, Vojdanparast M, Esfehani RJ, et al. Giant idiopathic pulmonary artery aneurysm: an interesting incidental finding. Case Rep Vasc Med. 2014;2014:251373.PubMedPubMedCentral Fazlinejad A, Vojdanparast M, Esfehani RJ, et al. Giant idiopathic pulmonary artery aneurysm: an interesting incidental finding. Case Rep Vasc Med. 2014;2014:251373.PubMedPubMedCentral
23.
Zurück zum Zitat Theodoropoulos P, Ziganshin BA, Tranquilli M, Elefteriades JA. Pulmonary artery aneurysms: four case reports and literature review. Int J Angiol. 2013;22(3):143–8.CrossRefPubMedPubMedCentral Theodoropoulos P, Ziganshin BA, Tranquilli M, Elefteriades JA. Pulmonary artery aneurysms: four case reports and literature review. Int J Angiol. 2013;22(3):143–8.CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Chiu P, Irons M, van de Rijn M, et al. Giant pulmonary artery aneurysm in a patient with Marfan syndrome and pulmonary hypertension. Circulation. 2016;133:1218–21.CrossRefPubMedPubMedCentral Chiu P, Irons M, van de Rijn M, et al. Giant pulmonary artery aneurysm in a patient with Marfan syndrome and pulmonary hypertension. Circulation. 2016;133:1218–21.CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Muthialu N, Raju V, Muthubaskaran V, et al. Idiopathic pulmonary artery aneurysm with pulmonary regurgitation. Ann Thoracic Surg. 2010;90(6):2049–51.CrossRef Muthialu N, Raju V, Muthubaskaran V, et al. Idiopathic pulmonary artery aneurysm with pulmonary regurgitation. Ann Thoracic Surg. 2010;90(6):2049–51.CrossRef
26.
Zurück zum Zitat van Rens MTM, Westermann CJJ, Postmus PE, Schramel FM. Untreated idiopathic aneurysm of the pulmonary artery; long-term follow-up. Respir Med. 2000;94(4):404–5.CrossRefPubMed van Rens MTM, Westermann CJJ, Postmus PE, Schramel FM. Untreated idiopathic aneurysm of the pulmonary artery; long-term follow-up. Respir Med. 2000;94(4):404–5.CrossRefPubMed
27.
Zurück zum Zitat Arslan S, Kalkan ME, Gündoǧdu F, Kantarci M. Idiopathic pulmonary artery aneurysm in a patient presenting with chest pain. Turk Kardiyoloji Dernegi Arsivi. 2009;37(4):253–5.PubMed Arslan S, Kalkan ME, Gündoǧdu F, Kantarci M. Idiopathic pulmonary artery aneurysm in a patient presenting with chest pain. Turk Kardiyoloji Dernegi Arsivi. 2009;37(4):253–5.PubMed
28.
Zurück zum Zitat Agarwal S, Chowdhury UK, Saxena A, et al. Isolated idiopathic pulmonary artery aneurysm. Asian Cardiovasc Thorac Ann. 2002;10(2):167–9.CrossRefPubMed Agarwal S, Chowdhury UK, Saxena A, et al. Isolated idiopathic pulmonary artery aneurysm. Asian Cardiovasc Thorac Ann. 2002;10(2):167–9.CrossRefPubMed
29.
Zurück zum Zitat Ritter CO, Weininger M, Machann M, et al. Non-invasive imaging in a rare case of main pulmonary artery aneurysm. Respir Med. 2008;102(5):790–2.CrossRefPubMed Ritter CO, Weininger M, Machann M, et al. Non-invasive imaging in a rare case of main pulmonary artery aneurysm. Respir Med. 2008;102(5):790–2.CrossRefPubMed
30.
Zurück zum Zitat Lopez-Candales A, Kleiger RE, Aleman-Gomez J, Kouchoukos NT, Botney MD. Pulmonary artery aneurysm: review and case report. Clin Cardiol. 1995;18:738–40.CrossRefPubMed Lopez-Candales A, Kleiger RE, Aleman-Gomez J, Kouchoukos NT, Botney MD. Pulmonary artery aneurysm: review and case report. Clin Cardiol. 1995;18:738–40.CrossRefPubMed
31.
32.
Zurück zum Zitat Nair KS, Cobanoglu AM. Idiopathic main pulmonary artery aneurysm. Ann Thorac Surg. 2001;71:1688–90.CrossRefPubMed Nair KS, Cobanoglu AM. Idiopathic main pulmonary artery aneurysm. Ann Thorac Surg. 2001;71:1688–90.CrossRefPubMed
33.
Zurück zum Zitat Ungaro R, Saab S, Almond CH, Kumar S. Solitary peripheral pulmonary artery aneurysms. Pathogenesis and surgical treatment. J Thorac Cardiovasc Surg. 1976;71(4):566–71.PubMed Ungaro R, Saab S, Almond CH, Kumar S. Solitary peripheral pulmonary artery aneurysms. Pathogenesis and surgical treatment. J Thorac Cardiovasc Surg. 1976;71(4):566–71.PubMed
34.
Zurück zum Zitat Butto F, Lucas JRV, Edwards JE. Pulmonary arterial aneurysm. A pathologic study of five cases. Chest. 1987;91(2):237–41.CrossRefPubMed Butto F, Lucas JRV, Edwards JE. Pulmonary arterial aneurysm. A pathologic study of five cases. Chest. 1987;91(2):237–41.CrossRefPubMed
35.
Zurück zum Zitat Sakuma M, Demachi J, Suzuki J, Nawata J, Takahashi T, Shirato K. Proximal pulmonary artery aneurysms in patients with pulmonary artery hypertension: complicated cases. Intern Med. 2007;46(21):1789–93.CrossRefPubMed Sakuma M, Demachi J, Suzuki J, Nawata J, Takahashi T, Shirato K. Proximal pulmonary artery aneurysms in patients with pulmonary artery hypertension: complicated cases. Intern Med. 2007;46(21):1789–93.CrossRefPubMed
36.
Zurück zum Zitat Hernández V, Ruiz-Cano MJ, Escribano P, Sánchez MA. Complications of proximal pulmonary artery aneurysm in patients with severe pulmonary arterial hypertension. Rev Esp Cardiol. 2010;63(5):617–8.CrossRef Hernández V, Ruiz-Cano MJ, Escribano P, Sánchez MA. Complications of proximal pulmonary artery aneurysm in patients with severe pulmonary arterial hypertension. Rev Esp Cardiol. 2010;63(5):617–8.CrossRef
37.
Zurück zum Zitat Kussman BD, Geva T, McGowan FX. Cardiovascular causes of airway compression. Paediatr Anesth. 2004;14:60–74.CrossRef Kussman BD, Geva T, McGowan FX. Cardiovascular causes of airway compression. Paediatr Anesth. 2004;14:60–74.CrossRef
38.
Zurück zum Zitat Arena V, De Giorgio F, Abbate A, Cappelli A, De Mercurio D, Carbone A. Fatal pulmonary arterial dissection and sudden death as initial manifestation of primary hypertension case report. Cardiovasc Pathol. 2004;13:349–71.CrossRef Arena V, De Giorgio F, Abbate A, Cappelli A, De Mercurio D, Carbone A. Fatal pulmonary arterial dissection and sudden death as initial manifestation of primary hypertension case report. Cardiovasc Pathol. 2004;13:349–71.CrossRef
39.
Zurück zum Zitat Chatterjee K, Colaco B, Colaco C, et al. Rasmussen's aneurysm: a forgotten scourge. Respir Med Case Rep. 2015;16:74–6.PubMedPubMedCentral Chatterjee K, Colaco B, Colaco C, et al. Rasmussen's aneurysm: a forgotten scourge. Respir Med Case Rep. 2015;16:74–6.PubMedPubMedCentral
40.
Zurück zum Zitat Keeling AN, Costello R, Lee MJ. Rasmussen's aneurysm: a forgotten entity? Cardiovasc Interv Radiol. 2008;31(1):196–200.CrossRef Keeling AN, Costello R, Lee MJ. Rasmussen's aneurysm: a forgotten entity? Cardiovasc Interv Radiol. 2008;31(1):196–200.CrossRef
41.
Zurück zum Zitat Santelli ED, Katz DS, Goldschmidt AM, Thomas HA. Embolization of multiple Rasmussen aneurysms as a treatment of hemoptysis. Radiology. 1994;193:396–8.CrossRefPubMed Santelli ED, Katz DS, Goldschmidt AM, Thomas HA. Embolization of multiple Rasmussen aneurysms as a treatment of hemoptysis. Radiology. 1994;193:396–8.CrossRefPubMed
42.
Zurück zum Zitat Remy J, Smith M, Lemaitre L, Marache P, Fournier E. Treatment of massive hemoptysis by occlusion of a Rasmussen aneurysm. Am J Roentgenol. 1980;135:605–6.CrossRef Remy J, Smith M, Lemaitre L, Marache P, Fournier E. Treatment of massive hemoptysis by occlusion of a Rasmussen aneurysm. Am J Roentgenol. 1980;135:605–6.CrossRef
43.
Zurück zum Zitat Shih SY, Tsai IC, Chang YT, et al. Fatal haemoptysis caused by a ruptured Rasmussen's aneurysm. Thorax. 2011;66(6):553–4.CrossRefPubMed Shih SY, Tsai IC, Chang YT, et al. Fatal haemoptysis caused by a ruptured Rasmussen's aneurysm. Thorax. 2011;66(6):553–4.CrossRefPubMed
44.
Zurück zum Zitat Raviglione MC, O’Brien RJ. Tuberculosis. In: Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson L, editors. Harrison’s principles of internal medicine. 16th ed. New York: McGraw Hill; 2005. p. 953–66. Raviglione MC, O’Brien RJ. Tuberculosis. In: Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson L, editors. Harrison’s principles of internal medicine. 16th ed. New York: McGraw Hill; 2005. p. 953–66.
45.
Zurück zum Zitat Kuwaki K, Morishita K, Sato H, et al. Surgical repair of the pulmonary trunk aneurysm. Euro J Cardiothoracic Surg. 2000;18(5):535–9.CrossRef Kuwaki K, Morishita K, Sato H, et al. Surgical repair of the pulmonary trunk aneurysm. Euro J Cardiothoracic Surg. 2000;18(5):535–9.CrossRef
46.
Zurück zum Zitat Casselman F, Deferm H, Peeters P, Vanermen H. Aneurysm of the left pulmonary artery: surgical allograft repair. Ann Thorac Surg. 1995;60:1423–5.CrossRefPubMed Casselman F, Deferm H, Peeters P, Vanermen H. Aneurysm of the left pulmonary artery: surgical allograft repair. Ann Thorac Surg. 1995;60:1423–5.CrossRefPubMed
47.
Zurück zum Zitat Sapra R, Sharma G, Minz AK. Rasmussen's aneurysm: a rare and forgotten cause of hemoptysis. Indian Heart J. 2015;67 Suppl 3:53–6.CrossRef Sapra R, Sharma G, Minz AK. Rasmussen's aneurysm: a rare and forgotten cause of hemoptysis. Indian Heart J. 2015;67 Suppl 3:53–6.CrossRef
Metadaten
Titel
Bilateral multiple pulmonary artery aneurysms associated with cavitary pulmonary tuberculosis: a case report
verfasst von
Pedro Pallangyo
Frederick Lyimo
Smita Bhalia
Hilda Makungu
Bashir Nyangasa
Flora Lwakatare
Pal Suranyi
Mohamed Janabi
Publikationsdatum
01.12.2017
Verlag
BioMed Central
Erschienen in
Journal of Medical Case Reports / Ausgabe 1/2017
Elektronische ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-017-1360-x

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