Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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A Case of Endobronchial Mass-Like Rasmussen Aneurysm

기관지내 종양 형태로 나타난 Rasmussen 동맥류 1예

  • Lee, Jeong Rok (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Lee, Su Hwa (Department of Family Medicine, College of Medicine, The Catholic University of Korea) ;
  • Jung, Sung Hoon (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Song, So Hyang (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Kim, Chi Hong (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Moon, Hwa Sik (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Song, Jeong Sup (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Park, Sung Hak (Department of Internal Medicine, College of Medicine, The Catholic University of Korea)
  • 이정록 (가톨릭대학교 의과대학 내과학교실) ;
  • 이수화 (가톨릭대학교 의과대학 가정의학교실) ;
  • 정성훈 (가톨릭대학교 의과대학 내과학교실) ;
  • 송소향 (가톨릭대학교 의과대학 내과학교실) ;
  • 김치홍 (가톨릭대학교 의과대학 내과학교실) ;
  • 문화식 (가톨릭대학교 의과대학 내과학교실) ;
  • 송정섭 (가톨릭대학교 의과대학 내과학교실) ;
  • 박성학 (가톨릭대학교 의과대학 내과학교실)
  • Published : 2004.01.30
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Abstract

A 69 year-old female was admitted to the hospital due to intermittent hemoptysis for 1 month. Emergent bronchoscopy revealed mass-like lesion almost completely obstructing right intermediate bronchus with multiple hemorrhagic spots. Bronchial arterial angiography was performed but failed to find out actively bleeding vessel. Spiral computerized tomography of the chest showed contrast enhanced bulging of the posterior portion of right main bronchus into the lumen of right intermediate bronchus suggesting Rasmussen aneurysm. The AFB smear of bronchial washing fluid was positive. Pulmonary arterial angiography and embolization were not performed due to improvement of clinical course with medical conservative care. Here we report a case of endobronchial mass-like Rasmussen aneurysm grossly suspected by bronchoscopy and diagnosed by spiral CT, which successfully managed by medical conservative care with antituberculous agents.

Rasmussen 동맥류는 공동성 폐결핵에 동반되어 종종 대량객혈을 일으킬 수 있어 임상적으로 중요하다. 그동안 이의 존재나 치료에 대한 보고는 간헐적으로 있어왔으나 본 증례와 같이 기관지내시경으로 직접 병변을 관찰하고 나선식 CT로 Rasmussen 동맥류의 존재를 확인한 경우는 없어 이에 보고하는 바이다. 또한 기관지 내시경 검사시 발견되는 종양 형태의 병변에는 이와 같은 혈관성병변도 있을 수 있으므로 생검 등의 침습적 검사시에 보다 신중해질 필요가 있으며, 기존 질환이 진행된 공동성 폐결핵일 경우에는 더욱 주의를 필요로 한다.

Keywords

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