Sunday, 2 June 2019

CASE 554: PULMONARY AVM, Dr PHAN THANH HAI, Dr TRAN THUY TRANG, MEDIC MEDICAL CENTER, HCMC, VIETNAM.


A 40 YO WOMAN in ANNUAL HEALTH CHECK UP, SHE HAS RECOGNIZED DULL LEFT CHEST PAIN FOR MANY YEARS.

US1: IN CROSSED SECTION OF SPLEEN AND LEFT LOWER PULMONARY LOBE INCIDENTALLY NOTES THAT A CYSTIC LESION IN LOWER LEFT LUNG TISSUE AND PLEURAL EFFUSION.



US2:  CDUS IN THIS CYSTIC LESION REPRESENTS YIN-YANG SIGN.


US3: SPECTRAL DOPPLER TRACE FROM THIS CYSTIC CONFIRMING ARTERIAL BLOOD FLOW.



US 4, US 5: THERE IS A PULMONARY ARTERIAL AND VENOUS FLOW BESIDE THE CYST.



MSCT CE:
CT1, CT2: FRONTAL VIEW CONFIRMS AN ANEURYSM IN THE LEFT LOWER LOBE WITH AN FEEDING ARTERY AND A DRAINING VEIN.


RADIOLOGICAL DIAGNOSIS IS A PULMONARY ARTERIOVENOUS MALFORMATION CASE.

OPEN SURGERY REMOVED LOWER  LOBE OF LEFT LUNG AND THE PULMONARY AVM.

MICROSCOPIC REPORT IS HAEMORRHAGE OF PULMONARY VASCULAR CONGESTION.



Conclusion:
This is a pulmonary AVM case incidentally found out in a pleural effusion that was discovered by ultrasound and confirmed by MSCT later.

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