[Massive hemoptysis in a patient with a tuberculous thoracic aneurysm]

A 91-year-old man with a history of pulmonary tuberculosis 20 years earlier came to our hospital because of hemoptysis in May 1993. A chest X-ray film showed infiltrative shadows in the left first arch of the cardiac silhouette, and sputum cultures were positive for Mycobacterium tuberculosis. Despite treatment with antituberculosis drugs, chest X-ray films revealed gradual progression, and he had occasional hemoptysis. He was admitted because of massive hemoptysis in December 1993 and a computed tomogram of the chest revealed an aneurysm of the descending aorta. Sudden and massive hemoptysis occurred in January 1994. At autopsy, the wall of the aneurysm and the surrounding tissue were found to have histological changes characteristic of tuberculosis. Tuberculous thoracic aneurysms are quite rare, but may develop in patients with tuberculosis in other areas.