J Korean Soc Emerg Med.  2016 Aug;27(4):379-383. 10.0000/jksem.2016.27.4.379.

Bronchial Artery Aneurysm Presenting Hemoptysis, Initially Mis-diagnosed as Bronchial Arterio-venous Malformation: A Case Report

• Cho HJ
• Lee JY
• Gu KM
• Lee HY
• Choi CW
• Kim Y
• Park TY
• Jung JW
• Choi JC
• Shin JW
• Kim JY
• Choi BW
• Park IW

• KMID: 2350893
• DOI: http://doi.org/10.0000/jksem.2016.27.4.379

Abstract

Normal bronchial arteries are small vessels that arise mostly from the descending thoracic aorta. Bronchial artery aneurysm is defined as a dilatation of the bronchial arteries with a diameter over 2 mm, and is reported in less than 1% of bronchial arterial angiography. A 70-year-old male patient was presented with hemoptysis. He had been treated for pulmonary tuberculosis 50 years ago. He also had a history of admission with hemoptysis 10 years ago, for which he was diagnosed as bronchiectasis on computed tomography imaging. Upon arrival to our hospital, abnormal vascular structure was detected on the mediastinum, arising from the descending thoracic aorta. It was dilated to 14 mm with a saccular form. Initially, we evaluated the structure as a bronchial arteriovenous malformation because it seemed to be drained into the pulmonary vein directly. For further evaluation, he had received a trans-catheter bronchial artery angiography. Both bronchial arteries were hypertrophied, but direct arteriovenous shunt was not detected; as such, we concluded this structure to be bronchial artery aneurysm. We performed embolization for both bronchial arteries and filled the aneurysm with coiling. He had no recurrence of hemoptysis and was discharged on 4 days post embolization. Our case reports an incidental bronchial artery aneurysm, which was initially misdiagnosed as bronchial arteriovenous anomaly, and finally treated with embolization and coiling.

Keyword

Aneurysm; Bronchial artery; Embolization; Hemoptysis

MeSH Terms

Aged
Aneurysm*
Angiography
Aorta, Thoracic
Arteriovenous Malformations
Bronchial Arteries*
Bronchiectasis
Dilatation
Hemoptysis*
Humans
Male
Mediastinum
Pulmonary Veins
Recurrence
Tuberculosis, Pulmonary