title: [Dieulafoy disease of the bronchus: 3 cases report with literature review].
abstract: OBJECTIVE
  To improve the understanding of bronchial Dieulafoy disease by summarizing the clinical and literature reported cases.
  
  
  METHODS
  The clinical data of 3 patients with bronchial Dieulafoy disease diagnosed by pathology from January 1, 2007 to May 31, 2012 in our hospital was collected and summarized. The data of 19 cases from literature case report regarding bronchial Dieulafoy disease both in Chinese and English were also reviewed through databases including Wanfang Data, National Knowledge Infrastructure, National Center for Biotechnology Information and Ovid Technologics from January 1, 2005 to May 31, 2012. The clinical characteristics, diagnosis and treatment of all the 22 cases were summarized and analyzed.
  
  
  RESULTS
  The average age of the 22 cases with bronchial Dieulafoy disease was (47 ± 15) years, and the preponderance was in male adults (16/22). Right lung (16/22) was more commonly involved than the left lung (4/22), and rarely in both lungs (2/22). Eight cases had smoking history, and 10 cases had underlying diseases such as tuberculosis.Sudden onset of massive hemoptysis was a common manifestation. Massive or lethal hemorrhage was often caused by biopsy injury. The abnormality of bronchial Dieulafoy disease was usually demonstrated as nodular lesions within the lumen of the bronchus.However, It was unable to determine their originating of the anomalous arteries in half of the cases(11/22). Most anomalous arteries confirmed by pathology were branched from bronchial artery (9/22), and rarely from pulmonary artery (2/22). The definitive diagnosis was made by pathological examination.Selective bronchial artery embolization and pulmonary lobectomy were the major therapeutic strategies, but bleeding may relapse after bronchial artery embolization, and lobectomy of the lung was a cure approach.
  
  
  CONCLUSIONS
  Bronchial Dieulafoy disease should be differentiated in patients with massive and unexplained hemoptysis.It takes a very high risk for biopsy, which rarely needs to be implemented. Bronchial arteriography and selective bronchial artery embolization should be promptly carried out to avoid life-threatening hemoptysis.Lobectomy could be an alternative choice for a cure.
authors.affiliation: Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Rui-hong
authors.initials: RH
authors.lastname: Yang
authors.forename: Jian-feng
authors.initials: JF
authors.lastname: Li
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
authors.forename: Kun-kun
authors.initials: KK
authors.lastname: Sun
authors.forename: Zhao-long
authors.initials: ZL
authors.lastname: Cao
authors.forename: Zhan-cheng
authors.initials: ZC
authors.lastname: Gao
mesh_terms: D000328:Adult; D000792:Angiography; D001981:Bronchial Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D001982:Bronchial Diseases / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D001999:Bronchoscopy; D004621:Embolization, Therapeutic; D005260:Female; D006469:Hemoptysis / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008168:Lung / Q000098:blood supply / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D012189:Retrospective Studies; D016896:Treatment Outcome