- 期刊
Air Crescent Sign: A Rare Presentation of Varicose Bronchiectasis with Hemoptysis
Air crescent sign-支氣管擴張症合併咳血之罕見表現
摘要
當影像學上出現Air crescent sign最常見的原因就是麴菌感染後形成麴菌球。麴菌球的成因是由許多菌絲聚集而成，通常不會造成明顯的症狀，但有些病人仍可能會以致命性的咳血來表現。其他可能造成air crescent sign的原因包括胞蟲囊體、其他黴菌感染、產生於之前結核病空洞中的血管瘤(Rasmussen aneurysm)、肺膿瘍、因金黃色葡萄球菌、綠膿桿菌或克雷白氏肺炎桿菌造成的壞死性肺炎、合併開洞表現之惡性腫瘤等疾病。支氣管擴張症合併嚴重咳血，過去並未曾被報導會在影像上呈現air crescent sign之變化。我們提出一位病患因支氣管擴張症合併嚴重咳血，而在胸部電腦斷層影像上呈現了air crescent sign。此病例可提醒臨床醫師，雖然臨床上有許多常見原因會導致電腦斷層影像上呈現air crescent sign，一旦發現病人影像上有air crescent sign且合併嚴重咳血，但在影像上卻有異乎尋常的快速變化時，除了考慮常見的鑑別診斷外，也應考慮病人可能有潛在的支氣管擴張症之問題。
並列摘要
The most common cause of the air crescent sign is aspergilloma resulting from saprophytic aspergillosis. The fungal ball consisting of condensed hyphae can vary in both size and number. Although saprophytic aspergillosis can be asymptomatic, patients may occasionally experience severe, life-threatening hemoptysis. Other causes of the air crescent sign include pulmonary hydatid cysts; lung colonization by other fungi; Rasmussen aneurysms in a tuberculous cavity; lung abscesses; bacterial necrotizing pneumonia caused by Staphylococcus aureus, Klebsiella pneumoniae, or Pseudomonas aeruginosa; and cavitating neoplasm of the lung. Bronchiectasis has not yet been reported as a cause of the air crescent sign. In this paper, we present a case of varicose bronchiectasis complicated with massive hemoptysis; a chest computed tomography (CT) scan of the patient showed the air crescent sign. Clinicians should therefore be aware that while there are several well-known causes of the appearance of the air crescent sign in a chest CT scan, varicose bronchiectasis complicated with severe hemoptysis should be considered as a diagnosis if rapid changes in the image occur during the follow-up period.