We presented a rare case of a 64-year-old man with a combined anomaly of the bronchus and pulmonary artery that was detected incidentally. Computed tomography showed a hyperlucent, aerated sequestered segment of the right lower lung with an independent ectopic bronchus, which had no connection to the other airway. The affected segment was supplied by its own aberrant pulmonary artery branch from the right pulmonary trunk. This anomaly cannot be classified with any of the previously reported anomalies.
Bronchi/pathology ; Bronchopulmonary Sequestration/*radiography ; Humans ; Lung/*radiography ; Male ; Middle Aged ; Pulmonary Artery/*radiography ; Tomography, X-Ray Computed

Optical coherence tomography (OCT) is a new imaging technique capable of obtaining high-resolution intravascular images and has been used in interventional cardiology. However, an application of OCT in pulmonary arteries had seldom been documented. In this case, OCT imaging is performed in peripheral pulmonary arteries and shows mural red thrombi. Subsequently, the red thrombi are aspirated and confirmed by a histological examination. These findings suggest that OCT may be a useful tool to depict peripheral pulmonary artery thrombi.
Adult ; Angiography ; Humans ; Male ; Pulmonary Artery/*pathology/radiography ; Pulmonary Embolism/*diagnosis ; Tomography, Optical Coherence/*methods ; Tomography, X-Ray Computed

This study assessed main pulmonary artery diameter of patients with anthracofibrosis. Patients with anthracofibrosis and CT scans were evaluated after exclusion of patients with co-existing disease. We measured the diameter of the main pulmonary artery (PAD) and ascending aorta (AD) and calculated the pulmonary artery to aorta ratio (APR). The upper reference limit for comparison of PAD was 29 mm. Cut-off values for PAD and APR indicating pulmonary hypertension were 33 mm and 1. We correlated the CT parameters with echocardiographic results. Total 51 patients were included in the analysis. The mean PAD, AD, and APR were 33 mm, 38 mm, and 0.87 respectively. The PAD was larger than the upper reference limit, 29 mm (P<0.001). The PAD was >33 mm in 30 (65%) and the APR was >1 in 9 patients (18%). Of 21 patients with echocardiography, 11 (52%) were found to have pulmonary hypertension. There was no statistical difference in the diagnosis of pulmonary hypertension between echocardiography and CT (P=1.000). In conclusion, main pulmonary artery is dilated in patients with anthracofibrosis more than in the healthy population.
Aged ; Aged, 80 and over ; Aorta, Thoracic/*radiography ; Bronchi/pathology ; Bronchoscopy ; Dilatation ; Female ; Fibrosis ; Humans ; Hypertension, Pulmonary/*diagnosis/ultrasonography ; Male ; Pulmonary Artery/*radiography ; Tomography, X-Ray Computed

Pulmonary artery intimal sarcoma is a rare highly lethal disease, with additional retrograde extension to pulmonic valve and right ventricle being an extremely rare condition. It is frequently mistaken for pulmonary thromboembolism. We report a case of 64-year-old woman with progressive dyspnea initially suspected and treated for pulmonary thromboembolism. Her helical chest CT scan with 3 dimensional (3D) reconstruction combined with echocardiography revealed a compacting main pulmonary artery mass extending to the right ventricular outflow tract and the right pulmonary artery. After excision of the mass, the patient's condition improved dramatically, and the pathologic findings revealed pulmonary intimal sarcoma. This report emphasizes that helical chest CT with 3D reconstruction can be an important tool to differentiate the characteristics of pulmonary artery lesions, such as intimal sarcoma and thromboembolism.
Diagnosis, Differential ; Echocardiography ; Female ; Human ; Imaging, Three-Dimensional ; Middle Aged ; Pulmonary Artery/pathology/*radiography ; Sarcoma/pathology/*radiography/ultrasonography ; Tomography, X-Ray Computed/*methods ; Tunica Intima/pathology/radiography ; Vascular Neoplasms/pathology/*radiography/ultrasonography

Pulmonary aspergillosis is classified as a saprophytic, allergic, and invasive disease. Chronic necrotizing pulmonary aspergillosis is categorized as an invasive pulmonary aspergillosis. Most invasive pulmonary aspergillosis have acute and toxic clinical features but chronic necrotizing pulmonary aspergillosis is characterized by a sub-acute infection, most commonly seen in patients with altered local defense system from preexisting pulmonary disease of in mild immunocompromised patients. Pulmonary artery aneurysm due to this infection is termed as a mycotic aneurysm, etiology of which are tuberculosis, syphilis, bacteria and fungus. We report a case chronic necrotizing pulmonary aspergillosis complicating pulmonary aneurysm is a 62 year-old man who was presented with cough, sputum, and fever. Chest radiographs showed a rapid, progressive cavitary lesion and pulmonary artery aneurysm. Angioinvastion of aspergillus was revealed by pathology after operative removal of left upper lobe containing the pulmonary artery aneurysm. He was treated with itraconazole.
Aneurysm* ; Aneurysm, Infected ; Aspergillus ; Bacteria ; Cough ; Fever ; Fungi ; Humans ; Immunocompromised Host ; Invasive Pulmonary Aspergillosis* ; Itraconazole ; Lung Diseases ; Pathology ; Pulmonary Artery* ; Pulmonary Aspergillosis ; Radiography, Thoracic ; Sputum ; Syphilis ; Tuberculosis

The rupture of an acute dissection of the ascending aorta into the space surrounding the pulmonary artery is an uncommon occurrence. No previous cases of transient pulmonary hypertension caused by a hematoma surrounding the pulmonary artery have been documented in the literature. Herein, we report a case of acute aortic dissection presenting as secondary pulmonary hypertension.
Aortic Aneurysm/*complications/diagnosis ; Aortic Rupture/*complications/diagnosis ; Constriction, Pathologic ; Female ; Hematoma/*complications ; Human ; Hypertension, Pulmonary/*etiology ; Middle Aged ; Pulmonary Artery/pathology/radiography ; Tomography, X-Ray Computed

PURPOSE: To evaluate the low attenuation of mosaic pattern in pulmonary embolism, as observed on HRCT, and to correlate the findings with the pathologic features of resected lung. MATERIALS AND METHODS: Using permanent embolic materials, pulmonary embolism was induced in eight Yorkshire pigs. Pre-and post-embolic pulmonary angiography was performed and after 6 weeks, the incidence and pattern of parenchymal change in low attenuation (mosaic pattern), as seen on HRCT, was evaluated. The animals were then sacrified and contact radiography of the lung was performed. Thirty-eight segments of pathology were taken from the area in which the presence of embolism had been suggested. Pathologic and HRCT findings were then correlated. RESULTS: On HRCT, low attenuation was seen in 23 of 36 segments (64%) and showed variable patterns : crescent peripheral hyperlucency (61%, n=14), heterogeneous mottled hyperlucency (17%, n=4), lobular hyperlucency (13%, n=3), and homogeneous segmental hyperlucency (9%, n=2). Parenchymal low attenuation was seen on HRCT in 10 of 11 segments (91%) in which large segmental arterial occlusion occurred, and in 3 of 16 segments (19%) in which there was small segmental arterial occlusion. Abnormal pathologic findings were pulmonary congestion, dilatation of pulmonary arteries, interlobular septal thickening, and thrombus formation. Among the 38 pathologic segmental specimens, 29 were from the area in which HRCT findings were positive, and in which pulmonary embolism subsequently occurred. In only four of nine segments (44%) in the area in which HRCT fingings were negative was pulmonary embolism subsequently. CONCLUSION: HRCT findings of pulmonary embolism at six weeks after embolization showed variable patterns of low attenuation, diminished diameter of pulmonary arteries, and normal diameter of bronchi. In cases with large segmental arterial occlusion, the finding of low attenuation was more common ; this may be due to reduced blood flow to the embolic area, in combination with bronchiolar spasm. For the early diagnosis of pulmonary embolism, these findings may be useful.
Angiography ; Animals ; Bronchi ; Dilatation ; Early Diagnosis ; Embolism ; Estrogens, Conjugated (USP) ; Incidence ; Lung ; Pathology ; Pulmonary Artery ; Pulmonary Embolism* ; Radiography ; Spasm ; Swine ; Thrombosis

We present a rare case of main pulmonary artery stenosis secondary to protruding fibrous material in the main pulmonary artery associated with patent ductus arteriosus. A 1-month-old baby boy manifested cardiac murmur. Echocardiogram showed circumferential high echogenic mass inside the main pulmonary artery with pressure gradient of 49 mmHg and patent ductus arteriosus. The mass did not regress during 3 months' follow-up period. Angiographic images showed that the circular filling defect was located at the main pulmonary artery distal to pulmonary valve, and pulmonary valve and both pulmonary arteries were normal. After surgical removal of the circumferential material and ductus ligation, the pressure gradient became negligible. The material was consisted of scarcely cellular fibrous tissue, abundant coagulum of fibrinous material and dense calcification.
Angiography ; Calcinosis ; Constriction, Pathologic/etiology/pathology/surgery ; Echocardiography ; Heart Murmurs ; Humans ; Infant ; Infant, Newborn ; Male ; Pulmonary Artery/*pathology/radiography/surgery/ultrasonography

Actins ; metabolism ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Kidney Neoplasms ; pathology ; Middle Aged ; Pulmonary Artery ; Pulmonary Embolism ; pathology ; Radiography ; Sarcoma ; diagnostic imaging ; metabolism ; pathology ; surgery ; Vascular Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Actins ; metabolism ; Desmin ; metabolism ; Diagnosis, Differential ; Female ; Hemangiosarcoma ; metabolism ; pathology ; Humans ; Leiomyosarcoma ; metabolism ; pathology ; Middle Aged ; Multimodal Imaging ; Pulmonary Artery ; pathology ; Radiography ; Sarcoma ; diagnostic imaging ; metabolism ; pathology ; Soft Tissue Neoplasms ; secondary ; Vascular Neoplasms ; diagnostic imaging ; metabolism ; pathology ; Vimentin ; metabolism