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Published on: May 14, 2020
[Surgical experience of idiopathic peripheral pulmonary arterial aneurysm; report of a case]
1Department of Thoracic Surgery, Ibarakiseinan Medical Center Hospital, Ibaraki, Japan.
Abstract:
Peripheral pulmonary arterial aneurysm has rarely been reported, and although most cases show symptoms of hemoptysis. We experienced a case of idiopathic peripheral pulmonary arterial aneurysm in the asymptomatic period noted on medical examination. The patient was a 49-year-old man with coin lesion which was 15 mm in diameter in the right lower lung field on chest X-ray film at the 1st visit. It was strongly stained on enhanced computed tomography in the right S4 and continuity with the pulmonary arteries was suggested. The right middle lobectomy was performed under the diagnosis of peripheral pulmonary arterial aneurysm. Histological examination of the resected specimen revealed that the prominent thinning in the arterial wall, however, there was no evidence of specific chronic inflammation. The postoperative course was good. The patient has been well without new pulmonary arterial aneurysm for 2 years after the surgery.
Insights
A rare case of idiopathic peripheral pulmonary arterial aneurysm was found incidentally in an asymptomatic patient. Surgical removal confirmed arterial wall thinning, with no inflammation, and the patient recovered well.
Area of Science:
- Cardiology
- Pulmonology
- Vascular Surgery
Background:
- Peripheral pulmonary arterial aneurysms are infrequently documented and often present with hemoptysis.
- Idiopathic cases are exceptionally rare, posing diagnostic challenges.
Observation:
- A 49-year-old male presented with an incidental 15 mm coin lesion in the right lower lung.
- Enhanced CT revealed a lesion in the right S4, suspected to be a pulmonary arterial aneurysm.
Findings:
- A right middle lobectomy was performed for a presumed peripheral pulmonary arterial aneurysm.
- Histopathology showed significant arterial wall thinning without evidence of chronic inflammation.
Implications:
- This case highlights the possibility of asymptomatic peripheral pulmonary arterial aneurysms detected incidentally.
- Early diagnosis and surgical intervention can lead to favorable outcomes for this rare condition.
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