PMC2698115_01
A 71-year-old man with mycotic pulmonary aneurysm caused by actinomycosis.. A. Chest radiograph shows focal parenchymal opacity with air-fluid level (arrow) in right upper lung zone. Pleural thickening with calcification due to previous tuberculous pleurisy is seen in left lower hemithorax.. B. Contrast-enhanced CT scan shows localized area of low attenuation (closed arrows) in superior segment of right lower lobe. Note hyperenhancing nodule (open arrow) with same attenuation as that of aorta.. C. Selective pulmonary angiogram of right lower lobe obtained before embolization shows peripheral pulmonary artery aneurysm (closed arrow). Feeding artery (open arrow) arises from superior segmental artery of right lower lobe.. D. Angiogram obtained after placement of coils (arrow) shows occlusion of aneurysm sac. Note no detectable staining of pulmonary aneurysm.
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F1
A chest radiograph obtained on admission showed oval-shaped opacity, with an air-fluid level in the right upper lung zone (Fig. 1A). In addition, a 1.5-cm hyperenhancing nodule, with the same attenuation as that of the aorta, was found within the lower portion of the lesion (Fig. 1B). A selective angiogram of the right pulmonary artery showed saccular dilatation of a peripheral pulmonary artery in the right lower lobe (Fig. 1C). Repeated angiography, performed on completion of the embolization, confirmed successful occlusion of the feeding artery, with no staining of the aneurysmal sac (Fig. 1D).