Presentation
Complains of dyspnea with a history of iliofemoral thrombosis. Pulmonologist requested pulmonary CT angiography to exclude chronic thromboembolism.
Patient Data
Pulmonary angiography shows no sign of thromboembolism.
There is a tortuous and dilated bronchial artery arising from the descending aorta with an aneurysm with calcified walls. Atherosclerosis of the aorta is also demonstrated.
The lungs exhibit mosaic pattern of attenuation with cystic bronchiectasis in the left lower lobe and inferior lingular segment. Fibrosis and cicatricial atelectasis are also demonstrated.
Other findings:
- nonspecific hypodense lesion in the lower pole of the spleen
- calcified plaques at the base of the renal arteries without significant stenosis
- hypodense nodule in the left lobe of the thyroid gland
- small gastric hiatal hernia
Case Discussion
In this case, the small bronchial artery aneurysm is an incidental finding and can hardly have real clinical significance. The occurrence of this aneurysm is most likely due to COPD and bronchiectasis in the left lung. Symptoms are due to COPD.