title: Pseudoaneurysm of brachiocephalic artery mimicking the mediastinal tumor.
abstract: 58 year-old male admitted to the Hospital of Lithuanian University of Health Sciences due to suspicion of mediastinal tumor for diagnostic endobronchial ultrasound procedure (EBUS). The main patient's complain was progressive dyspnea. Objective investigation revealed no major findings: normal breath sounds, heart rate - 96 bpm, blood pressure - 120/80 mmHg. Chest CT scan showed the mediastinal tumor of 3.8 × 3.5 cm. During bronchoscopy smooth intratracheal nodule of 5 mm was found. Superficial biopsy showed normal airway mucosa. During EBUS procedure no clear lymph node structure or blood flow was detected. It was decided to observe the patient clinically. One month later massive hemoptysis started. Urgent bronchoscopy revealed large right-sided mass and intratracheal wall dislocation due to the possible mediastinal tumor in the same location as the polyp in the previous investigation. Repeated chest CT scan showed increasing tumor of size 4.0 × 3.2 × 4.0 cm in the mediastinum and pseudoaneurysm of brachiocephalic artery was suspected. The diagnosis was later confirmed by aortography. The patient underwent successful aneurysmectomy.
authors.affiliation: Department of Pulmonology and Immunology, Lithuanian University of Health Sciences, Eivienių 2, LT-50009 Kaunas, Lithuania.
authors.forename: Skaidrius
authors.initials: S
authors.lastname: Miliauskas
authors.affiliation: Department of Heart, Thoracic and Vascular Surgery, Lithuanian University of Health Sciences, Eivienių 2, LT-50009 Kaunas, Lithuania.
authors.forename: Rimantas
authors.initials: R
authors.lastname: Benetis
authors.affiliation: Department of Pulmonology and Immunology, Lithuanian University of Health Sciences, Eivienių 2, LT-50009 Kaunas, Lithuania.
authors.forename: Marius
authors.initials: M
authors.lastname: Zemaitis
authors.affiliation: Department of Radiology, Lithuanian University of Health Sciences, Eivienių 2, LT-50009 Kaunas, Lithuania.
authors.forename: Jurgita
authors.initials: J
authors.lastname: Zaveckiene
authors.affiliation: Department of Pulmonology and Immunology, Lithuanian University of Health Sciences, Eivienių 2, LT-50009 Kaunas, Lithuania.
authors.forename: Raimundas
authors.initials: R
authors.lastname: Sakalauskas
keywords: Endobronchial ultrasound; Mediastinal tumor; Pseudoaneurysm