Tuberc Respir Dis.  2008 Jan;64(1):28-32. 10.4046/trd.2008.64.1.28.

A Case of Pulmonary Arterial Thrombosis in a Patient with Tuberculous-destroyed Lung and Pulmonary Hypertension

• Lee JE
• Kim JH
• Kang MK
• Park HJ
• Lee JH
• Kim EK
• Lee YK
• Jeong HC

• KMID: 1478138
• DOI: http://doi.org/10.4046/trd.2008.64.1.28

Abstract

Pulmonary arterial thrombosis develops during hypercoagulable states, intra-arterial tumorous conditions, and congenital heart disease accompanied by pulmonary hypertension. Thrombosis in the main pulmonary arterial stump after pneumonectomy can also occur. Herein, we report a very rare case of pulmonary arterial thrombosis in a patient with pulmonary hypertension and a lung destroyed by tuberculosis. He presented with aggravated dyspnea without fever or purulent sputum. His chest computerized tomography scan showed left main pulmonary arterial thrombosis as a convex shape, with the ipsilateral distal arteries and arterioles showing parenchymal destruction. After excluding pulmonary thromboembolism and hypercoagulable disorders, we diagnosed pulmonary arterial thrombosis and treated him with an anticoagulant.

Keyword

Pulmonary arterial thrombosis; Tuberculous-destroyed lung; Pulmonary hypertension

MeSH Terms

Arteries
Arterioles
Dyspnea
Fever
Heart Diseases
Humans
Hypertension, Pulmonary
Lung
Pneumonectomy
Pulmonary Embolism
Sputum
Thorax
Thrombosis
Tuberculosis

Figure

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  Figure 1 Chest X-ray on the first day at the hospital shows increased opacity in left lung with traction bronchiectasis and multiple calcified nodules.

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  Figure 2 Lung setting of chest CT shows decreased lung volume, bullous emphysema, traction bronchiectasis, architectural distortion and multiple small calcifications in right upper lobe, superior segment of right lower lobe and left lung.

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  Figure 3 Contrast enhanced chest CT on the first day shows focal filling defect with convex-shape thrombus in left main pulmonary artery.

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  Figure 4 Contrast enhanced chest CT after anticoagulation for 2 weeks shows decreased size of thrombus in left main pulmonary artery.

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