Pulmonary artery pseudoaneurysm arising secondary to cavitary pneumonia

Abstract

Pulmonary artery pseudoaneurysms have classically been associated with the cavitary lesions of reactivation tuberculosis and termed Rasmussen's aneurysm. There have been relatively few case reports of pulmonary artery pseudoaneuryms arising secondary to cavitary pneumonia. We present a case of pulmonary artery pseudoaneurysm occurring secondary to cavitating aspiration pneumonia that was treated successfully with coil embolization.

Keywords: CT, computed tomography.

Figure 1

60-year-old African-American male with pulmonary artery pseudoaneurysm. Axial, contrast-enhanced CT image viewed in soft tissue (A) and lung windows (B) demonstrates consolidation of the posterior segment of the right upper lobe with cavity formation and adjacent contrast blush, consistent with active extravasation. (C) Coronal reformatted image.

Figure 2

60-year-old African-American male with pulmonary artery pseudoaneurysm. Oblique coronal MIP image demonstrating pseudoaneurysm (arrow) communicating with pulmonary arterial system.Oblique, coronal MIP image demonstrates pseudoaneurysm (arrow) communicating with pulmonary arterial system.

Figure 3

60-year-old African-American male with pulmonary artery pseudoaneurysm. A. Late parenchymal phase. Pulmonary venous phase (B) and arterial phase images (C) demonstrate small right upper-lobe pulmonary arterial pseudoaneurysm.

Figure 4

60-year-old African-American male with pulmonary artery pseudoaneurysm. Subselective pulmonary arteriogram demonstrating pseudoaneurysm.

Figure 5

60-year-old African-American male with pulmonary artery pseudoaneurysm. Microcatheter at the neck of the pseudoaneurysm.

Figure 6

60-year-old African-American male with pulmonary artery pseudoaneurysm. Subselective pulmonary arteriogram demonstrates successful coiling of pseudoaneurysm.