PMC9139337_01
Chest CT showing: diffusely distributed nodules in both lungs, bilateral bronchiolitis, and tuberculosis could not be excluded. The aortic arch was thickened, and the local calcified plaque moved inward, which indicated further aortic CTA examination.
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The aortic arch was thickened and the local calcified plaque moved inward, which indicated further aortic computed tomography angiography (CTA) examination (Figure 1).
Chest CTA showing: multiple atherosclerosis and ulcers, and intermural hematoma formation in the aortic arch and thoracic aorta. Combined with the patient's diagnosis of miliary tuberculosis, the involvement of tuberculosis in the aorta should be highly suspected.
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CTA confirmed multiple atherosclerosis and ulcers, and intermural hematoma in the aortic arch and thoracic aorta. Combined with the medical history, the involvement of tuberculosis in the aorta should be highly suspected (Figure 2).
Chest CT showing: bronchiole lesions and multiple miliary foci in both lungs with pleural effusion and slightly thickened pleura. This combined with the medical history is consistent with the diagnosis of hematogenous disseminated pulmonary tuberculosis.
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Re-examination of lung CT revealed bronchiole lesions and multiple miliary foci in both lungs, which were larger than one week prior, with pleural effusion, and slightly thickened pleura, suggestive of miliary tuberculosis (Figure 3).
Chest CT showing: partially absorption of the miliary foci, suggesting that anti-tuberculosis treatment is effective.
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After two weeks of treatment, the patient's body temperature returned to normal, and a re-examination of the lung CT indicated that the lesion was partially absorbed (Figure 4).
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Thoracic and abdominal aortic CTA showing: localized sachet-like enlargement of the lower abdominal aorta, with a size of 51x28 mm2, surrounded by patchy shadow and lymphadenopathy, which are consistent with the manifestations of aortic pseudoaneurysm. Combined with the medical history, tuberculosis caused aortic pseudoaneurysm is considered.
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CTA examination showed a 51x28 mm2 pseudoaneurysm arising from the lower abdominal aorta, surrounded by a patchy shadow and lymphadenopathy (Figure 5). Combined with the patient's medical history, tuberculous aortic pseudoaneurysm was considered.
Abdominal aortic CTA showing: no recurrence of the abdominal aortic aneurysm.
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Abdominal aortic CTA performed two weeks later revealed that the aneurysm did not recur (Figure 6).