Image of the Month—Diagnosis

Abstract

P ulmonary artery pseudoaneurysm is a rare complication that often presents with hemoptysis. 1,2 The etiology of pulmonary artery pseudoaneurysm are varied. Infectious causes include bacterial pneumonia, 2 tuberculosis (Rasmussen aneurysm), 3 and mucormycosis. 4 Inflammatory diseases, such as Behc ¸et disease, are known to cause pulmonary artery pseudoaneurysms. 5,6 They may also arise after blunt or penetrating trauma. 7,8 Pulmonary artery pseudoaneurysms have also been attributed to malignancies, such as lung carcinoma, 9 sarcoma, 10 and bullous emphysema. 11 Iatrogenic causes include bronchial artery anhiography 12 and pulmonary artery catheterization, 13,14 radiofrequency ablation, 15 lung resection, 16 and pneumonectomy. 17 To our knowledge, this is the first case of pulmonary artery pseudoaneurysm reported after VATS.The diagnosis of pulmonary artery pseudoaneurysms has been simplified with improved computed tomographic angiography, but subselective angiography of the segmental pulmonary arteries provides more detailed anatomical information and potential treatment (Figure 2A). 18 Although historically the treatment of pulmonary artery pseudoaneurysms required surgical repair, percutaneous techniques, such as transcatheter coil embolization 19,20 (Figure 2B) and stent grafting 21 of the main pulmonary arteries, have become the first-line treatment modality.