title: Pulmonary Artery Aneurysm/Pseudoaneurysm, a Delayed Complication of Lung Abscess: A Case Report.
abstract: BACKGROUND
  Massive hemoptysis mostly arises from the bronchial arteries; however, bleeding can also occur from a lesion in injured pulmonary arteries, such as pulmonary artery aneurysm/pseudoaneurysm (PAA/PAP), during pulmonary infection.
  
  
  METHODS
  A 66-year-old man was admitted with a diagnosis of lung abscess in the right lower lobe that was complicated with pyothorax. Intravenous administration of antibiotics and thoracic drainage successfully controlled the infection and inflammation until day 16, when the patient began to exhibit hemoptysis and bloody pleural effusion. Enhanced computed tomography (CT) with multi-planer reconstruction (MPR) images showed a highly enhanced mass inside the abscess fed by the pulmonary artery, suggesting PAA/PAP. Pulmonary angiography confirmed PAA/PAP, and embolization with coils successfully stopped both the bleeding into the sputum and pleural effusion, with a collapsed aneurysm visible on chest CT scan.
  
  
  CONCLUSIONS
  Clinicians should consider the possibility of PAA/PAP in the differential diagnosis of hemoptysis during the treatment of patients with lung abscess. MPR CT is helpful for the diagnosis of PAA/PAP and its feeding vessels.
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan. tyoguma@tokai-u.jp.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Oguma
authors.forename: Masahiro
authors.initials: M
authors.lastname: Morise
authors.forename: Kazuki
authors.initials: K
authors.lastname: Harada
authors.forename: Jun
authors.initials: J
authors.lastname: Tanaka
authors.forename: Masako
authors.initials: M
authors.lastname: Sato
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Horio
authors.forename: Hiroto
authors.initials: H
authors.lastname: Takiguchi
authors.forename: Hiromi
authors.initials: H
authors.lastname: Tomomatsu
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Tomomatsu
authors.forename: Takahisa
authors.initials: T
authors.lastname: Takihara
authors.forename: Kyoko
authors.initials: K
authors.lastname: Niimi
authors.forename: Naoki
authors.initials: N
authors.lastname: Hayama
authors.forename: Takuya
authors.initials: T
authors.lastname: Aoki
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Urano
authors.forename: Chihiro
authors.initials: C
authors.lastname: Ito
authors.forename: Jun
authors.initials: J
authors.lastname: Koizumi
authors.forename: Koichiro
authors.initials: K
authors.lastname: Asano
mesh_terms: D000368:Aged; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000628:therapy*; D000792:Angiography; D003937:Diagnosis, Differential; D004621:Embolization, Therapeutic / Q000379:methods; D017809:Fatal Outcome; D006469:Hemoptysis / Q000209:etiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008169:Lung Abscess / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D013995:Time; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome