PMC7132983_01
Case presentation. A patient in his late thirties with HIV, tuberculosis (4-drug treatment in 2009), and LUL cavitary lesion with aspergilloma presenting with life-threatening hemoptysis. a Single image from axial computed tomography shows aspergilloma (arrowhead), which was the likely etiology of this patient's hemoptysis. b Flush thoracic aortogram demonstrates hypertrophied bronchial arteries (curved arrow) and superior intercostal arteries (straight arrow) supplying the aspergilloma. c Representative image of selective angiogram of the larger of the 2 left bronchial arteries shows hypertrophied bronchial artery (curved arrow). d Angiogram of the bronchial artery (curved arrow) post-bronchial artery embolization with 300-500 mum particles (trisacryl gelatin microspheres) via selective microcatheter demonstrates lack of blood flow to the area of the aspergilloma. e Angiogram of the left subclavian artery to evaluate for non-bronchial systemic collaterals demonstrates abnormal neovascularity filling from the left internal mammary artery (straight arrow) and lateral thoracic artery (curved arrow) on the left side. f Representative image of selective angiogram of the lateral thoracic branch on the left. g Angiogram shows inflammatory neovascular blush (arrowhead) with shunting to the main pulmonary artery (straight arrow). h Post-procedural angiogram with 500-700 and 700-900 mum particles demonstrates successful embolization of the lateral thoracic branch on the left.
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Fig2
Chest X-ray showed a cavitary left upper lobe lesion, and CT scan confirmed a large, thick-walled cavitary lesion in the left upper lobe (Fig. 2). He underwent angiography with successful embolization of two left bronchial arteries, the left internal mammary artery, and left lateral thoracic artery (Fig. 2).
PMC7132983_02
PMC7132983_03
PMC7132983_04