Interventional management of aspergillus-related pulmonary artery pseudoaneurysm and hemoptysis

Abstract

Pulmonary artery pseudoaneurysms are rare but life-threatening vascular abnormalities. Only less than 10% hemoptysis cases are of pulmonary artery origin while most cases arise from bronchial arteries. When diagnosed, they are mostly found to accompany pre-existing cardiovascular disease, infection, (i.e. Tuberculosis or Aspergillosis), vasculitis, trauma and/or neoplastic conditions. There are rare reports of pulmonary artery pseudoaneurysms being caused by direct extension of invasive fungal infections. We report a case of a rapidly growing pulmonary artery pseudoaneurysm in a 20-year-old female with lymphoma involving the lung and mediastinum. The patient was hospitalized with complications, including hemoptysis in the setting of Aspergillus Pneumonia and respiratory failure requiring intubation. Interventional Radiology was consulted after multiple bronchoscopic interventions failed to stabilize the bleeding. Patient then underwent embolization of the left subsegmental pulmonary artery pseudoaneurysm, with resolution of hemoptysis the next day.