J Korean Soc Radiol.  2016 Sep;75(3):218-221. 10.3348/jksr.2016.75.3.218.

A Case of Pseudoaneurysm Due to Fungus Ball within the Progressive Massive Fibrosis in a Patient with Pneumoconiosis: Computed Tomography-Pathologic Correlation

• Lee SG
• Ryu DS
• Park MS
• Choi SJ
• Kang CH
• Shin DR
• Ahn JH

• KMID: 2349329
• DOI: http://doi.org/10.3348/jksr.2016.75.3.218

Abstract

We reported a case of pseudoaneurysm in the upper lobar branch of the right pulmonary artery, which was caused by a fungus ball within the progressive massive fibrosis (PMF) in a patient with pneumoconiosis. Coil embolization of the pseudoaneurysm initially stopped the bleeding. After right upper lobe lobectomy to prevent the recurrent hemoptysis, pathology confirmed pseudoaneurysm within the PMF due to aspergilloma.

MeSH Terms

Aneurysm
Aneurysm, False*
Aspergillosis
Embolization, Therapeutic
Fibrosis*
Fungi*
Hemoptysis
Hemorrhage
Humans
Pathology
Pneumoconiosis*
Pulmonary Artery
Thorax

Figure

• 

  Fig. 1 Pseudoaneurysm due to fungus ball within the progressive massive fibrosis in a 51-year old patient, presenting with hemoptysis. A. Coronal reconstruction image (lung window) shows multiple well-defined centrilobular nodules, mainly distributed in the corticomedullary junction of the lung (small arrows) suggestive of pneumoconiosis. Also in addition, multiple small costal pleural and fissural nodules (large arrows) indicate perilymphatic distribution of pneumoconiotic nodules. B. Contrast-enhanced CT scan (mediastinal settings, 2.5 mm collimation) shows focus of enhancement suggesting pseudoaneurysm of segmental pulmonary artery in right upper lobe (large arrow). Spongiform air bubble suggesting a fungus ball within progressive massive fibrosis (PMF) (small arrow). C, D. Coronal and sagittal reconstruction images show pseudoaneurysm (arrow) of right upper lobe by fungus ball in PMF. E. Right pulmonary artery selective angiography shows a pseudoaneurysm (arrow) of segmental pulmonary artery in right upper lobe. F. Transcatheter embolization was performed with use of 4–5 mm coils (arrow) via the right femoral venous approach. G, H. Hematoxylin & eosin stain (× 40) and B (× 100) show fungus ball in the cavity of PMF.

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