A 43-year gentleman with recurrent hemoptysis, recurrent genital and oral ulcers since 5 years.
March 22, 2021
A 43-year gentleman with recurrent hemoptysis, recurrent genital and oral ulcers since 5 years.
- Fig 1 & 2. Axial and Sagittal contrast CT Pulmonary angiogram images demonstrate a large saccular aneurysm arising from the superior segmental artery of right lower lobar pulmonary artery with diffuse wall thickening – probable eccentric thrombus. There is compression of distal lower lobe segmental pulmonary arteries by the aneurysm (arrow).
- Fig 3. Axial CT image Lung window: Perifocal ground glass opacity along the saccular aneurysm in the right lower lobe.
- Fig 4. VR image of pulmonary artery aneurysm.
Post coiling of pulmonary artery aneurysm.
DIAGNOSIS:
Right pulmonary artery aneurysm with partial eccentric thrombus.
DISCUSSION:
Behçet disease is a multisystemic and chronic relapsing inflammatory disorder characterized by the histopathologic finding of nonspecific vasculitis involving various sized vessels in multiple organs.
Key imaging manifestations are:
- Pulmonary thromboembolism.
- Pulmonary artery aneurysm.
- Sinus of Valsalva aneurysm.
- SVC syndrome.
- Intracardiac thrombosis.
- Mediastinal fibrosis.
- Intestinal ulceration (and inflammatory changes).
- Budd-Chiari syndrome.
- Cerebral venous thrombosis.
- Identification of a vascular lesion is important because it seriously affects a patient’s prognosis. The leading cause of sudden death in patients with Behçet disease is rupture of a large aortic or arterial aneurysm
- To improve the detection of these various radiologic findings, examinations should be well-selected and optimized in patients with Behçet disease.
REFERENCES:
- Mehdipoor G, Davatchi F, Ghoreishian H, Shabestari AA. Imaging manifestations of Behcet’s disease: key considerations and major features. European journal of radiology. 2018 Jan 1;98:214-25.
- Chae EJ, Do KH, Seo JB, Park SH, Kang JW, Jang YM, Lee JS, Song JW, Song KS, Lee JH, Kim AY. Radiologic and clinical findings of Behçet disease: comprehensive review of multisystemic involvement. Radiographics. 2008 Sep;28(5):e31.
Case contributed by:
Dr. Deepali Saxena,
DNB, Fellowship Cardiothoracic Imaging (USA)
Lead Cardiothoracic Imaging
Manipal Hospitals Radiology Group.
Unit coordinator, Whitefield
DNB, Fellowship Cardiothoracic Imaging (USA)
Lead Cardiothoracic Imaging
Manipal Hospitals Radiology Group.
Unit coordinator, Whitefield
Dr. Vivek Jirankali,
MD
Senior resident and cross-sectional fellow
Manipal Hospitals Radiology Group.
MD
Senior resident and cross-sectional fellow
Manipal Hospitals Radiology Group.
