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Pseudoaneurysm of internal mammary artery caused by pulmonary actinomycosis

N A Wani1, I A Rawa, N A Pala

  • 1Department of Radiodiagnosis and Imaging, Sher-I- Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu & Kashmir, India. ahmad77chinar@hotmail.com

The British Journal of Radiology
|October 23, 2010
PubMed

Insights

Pulmonary actinomycosis, a rare lung infection, can cause internal mammary artery pseudoaneurysms, a previously unreported complication. This case highlights the importance of considering actinomycosis in patients with chest wall symptoms and vascular abnormalities.

Area of Science:

  • Medical Imaging
  • Infectious Diseases
  • Vascular Surgery

Background:

  • Internal mammary artery pseudoaneurysms are uncommon vascular issues, typically arising post-sternotomy, vascular access procedures, or chest trauma.
  • Pulmonary actinomycosis is a bacterial infection that can lead to lung abscesses and chest wall involvement.

Observation:

  • A 50-year-old woman presented with pneumonia symptoms, later developing hemoptysis and chest wall pain.
  • Multidetector CT angiography revealed a cavitating lung mass consistent with pulmonary actinomycosis and a pseudoaneurysm of the left internal mammary artery.

Findings:

  • This case represents the first documented instance of internal mammary artery pseudoaneurysm secondary to pulmonary actinomycosis.
  • Histopathology confirmed pulmonary actinomycosis as the cause of the lung mass and associated vascular complication.

Implications:

  • This finding expands the known clinical spectrum of pulmonary actinomycosis complications.
  • Clinicians should consider actinomycosis in the differential diagnosis for patients presenting with unexplained chest wall masses, pseudoaneurysms, and hemoptysis.
  • Advanced imaging like MDCT angiography is crucial for diagnosing complex cases involving infectious and vascular pathologies.

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