Tuberc Respir Dis.  2006 Dec;61(6):585-590. 10.4046/trd.2006.61.6.585.

A Case of Video-Assisted Thoracoscopic Pneumonectomy for Unilateral Diffuse Pulmonary Arteriovenous Malformation

Affiliations
  • 1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. ysamkim@yumc.yonsei.ac.kr
  • 2Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Korea.
  • 3Department of Diagnostic Radiology, Yonsei University College of Medicine, Seoul, Korea.
  • 4The Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea.

Abstract

Pulmonary arteriovenous malformations (PAVMs) are abnormal direct communications between the pulmonary arteries and veins. PAVMs may occur as either an isolated abnormality or in association with hereditary hemorrhagic telangiectasia, also called Osler-Weber-Rendu disease. The topic of PAVM has recently been extensively reviewed, but little is known about the clinical characteristics and course of patients having a diffuse pattern of the disease. Herein, is reported a case of unilateral diffuse PAVM in an 18 year old female patient, who underwent a right pneumonectomy, under a video-assisted thoracic surgery (VATS) approach, as the diffuse small pulmonary arteriovenous malformation involved the whole right lung.

Keyword

Diffuse; Pulmonary; Arteriovenous malformation

MeSH Terms

Adolescent
Arteriovenous Malformations*
Female
Humans
Lung
Pneumonectomy*
Pulmonary Artery
Telangiectasia, Hereditary Hemorrhagic
Thoracic Surgery, Video-Assisted
Veins

Figure

  • Figure 1 Chest roentgenogram showed minimal parenchymal infiltration on right parahilar area at admission.

  • Figure 2 Chest CT scan showed slightly dilated tortuous pulmonary arteries and pulmonary veins (long arrow) in right segment 1, 2, 3, 6, 7, 8, 9, 10. Hypertrophied bronchial arteries and mediastinal collaterals through right pulmonary ligament.

  • Figure 3 Main pulmonary arteriography showed innumerable tiny saccular aneurysms on the whole right pulmonary artery peripheral portion and early venous drainage (A). Selective right interlobar pulmonary artery and upper lobar pulmonary artery angiography demonstrated innumerable tiny saccular aneurysms and early venous drainage (B).

  • Figure 4 3-Dimentionally reconstructed CT scan showed diffuse pulmonary arteriovenous malformations on the right Lung.(A) Magnified Image of the right Lung (B)

  • Figure 5 The specimen showed geographic hemorrhage in the superior segment of lower lobe. On section, multiple dilated blood vessels and multifocal hemorrhage are noted


Reference

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