Interstitial pulmonary hemorrhage from mediastinal hematoma secondary to aortic rupture

The chest radiograph of a 79-year-old man with acute thoracic aortic rupture demonstrated enlarged, ill-defined bronchovascular markings. Examination of the lungs at autopsy revealed extensive dissection of blood from the mediastinum along the bronchovascular sheaths. Recognition that enlarged bronchovascular markings may represent hemorrhage rather than edema in the setting of acute aortic rupture has important therapeutic implications.