IS Case 306: Bronchial artery aneurysm with fistulous connection with the pulmonary arterial system

Ahmed El-Sherief, MD

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Imaging Sciences URMC 2009
Publication Date: 2009-08-06

History

Patient is a 57-year-old female with incidental finding of bronchial artery aneurysm noted on chest CT.

Findings

Bronchial artery aneurysm with fistulous connection with the pulmonary arterial system.

Diagnosis

Bronchial artery aneurysm with fistulous connection with the pulmonary arterial system

Discussion

Key facts:

• Bronchial artery aneurysm is a rare entity.
• In all patients who undergo selective bronchial arteriography, it is noted <1% of the time.
• Due to potential risk of life threatening rupture, bronchial artery aneurysms should be treated.

Classification:

• Intrapulmonary (can present with intermittent / massive hemoptysis)
• Mediastinal (can present as superior vena cava obstruction, dysphagia, hemothorax, hemomediastinum, and hematemesis)

Treatment:

• Transcatheter embolization (first line of treatment)
• Surgical resection / ligation

References

1. Zhang LJ, Yang GF, Lu GM. Noninvasive diagnosis of bronchial artery aneurysm using dual-source computed tomography angiography. Acta Radiol. 2008 Apr;49(3):291-4. PMID: 18365817 [PubMed]
2. Wilson SR, Winger DI, Katz DS. CT visualization of mediastinal bronchial artery aneurysm. AJR Am J Roentgenol. 2006 Nov;187(5):W544-5. PMID: 17056888 [PubMed]