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Systemic to pulmonary arteriovenous fistula in a patient with tuberculosis sequels: A sign of inflammatory neoangiogenesis
並列摘要
Introduction: The study of the causes of hemoptysis entails multiple diagnostic choices and tests. However, in 30% of the cases, a cause is not clearly identified (cryptogenic hemoptysis). Even though pulmonary arteriovenous malformations are uncommon, they must be taken into account as possible causes of hemoptysis. Particularly, acquired systemic-to-pulmonary vascular fistulas are atypical and represent both diagnostic and therapeutic challenges. Case Report: We describe a case of systemic to pulmonary arteriovenous malformation between the internal mammary and right subclavian arteries to the upper lobe pulmonary veins, in a 47-yearold male with a past history of pulmonary tuberculosis who presented with hemoptysis. The patient had received anti-tuberculous treatment in another institution after he was diagnosed with pulmonary tuberculosis made conclusive by positive smear tests and chest radiologic examination. He was subsequently treated on a second occasion in spite of the negative smears following the first treatment because of the persistent hemoptysis. Despite recurrent hemoptysis, the patient was brought to our institution six years after the beginning of the hemoptysis. Pulmonary arteriography was done revealing a right internal mammary and subclavian arteriovenous malformation in communication with the vessels of the right upper pulmonary lobe, which was successfully treated with endovascular embolization. Conclusion: We believe systemic to pulmonary fistulas can represent a sign of inflammatory pulmonary and extrapulmonary neoangiogenic process.
延伸閱讀
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