Pulmonary arterial aneurysm
Updates to Article Attributes
Pulmonary arterial aneurysms refer to a focal dilatation of the pulmonary arterial system.
Epidemiology
Overall it is considered a rare entity with autopsy prevalence rates of around 1 in 14,000 to 100,000 4-5.
Pathology
A true pulmonary artery aneurysm results from dilatation of all three layers of the vessel wall while a pulmonary artery pseudoaneurysm does not involve all layers of the arterial wall. Most of the aneurysms are central, affecting the main pulmonary arteries 4.
Aetiology
The differential for etiologies of pulmonary artery aneurysms can be broad. Different sources differ as to the most frequent etiologiesaetiologies, likely due to the rarity of the entity and reliance on limited case series.
- vascular
-
pulmonary arterial hypertension 3, 12
- pulmonary valvular / postvalvular stenosis and regurgitation 11
- cystic medial degeneration
-
pulmonary arterial hypertension 3, 12
- infectious
- mycotic aneurysm (e.g. IV drug users)
- tuberculosis: Rasmussen aneurysm
- syphilis
- traumatic (often pseudoaneurysm)
- blunt or penetrating trauma, most commonly extravascular due to stab wound 9
- iatrogenic, most commonly endovascular due to malpositioned pulmonary artery catheter 9
- autoimmune
- Behcet disease (most common)10 and its variant Hughes-Stovin syndrome 7
- giant cell arteritis
- idiopathic 4
- congenital
- congenital left-to-right shunts, most commonly patent ductus arteriosus
Radiographic features
Plain radiograph
Radiographic features are non-specific and they may appear as hilar enlargement or a lung nodule.
CT
CT angiography (CTA) allows a much better appreciation of the anatomy. Some consider enlargement or ectasia of the pulmonary trunk on CT scan to be 29 mm and the right interlobar artery to be 17 mm1. Proximal pulmonary artery aneurysms are defined by pulmonary trunk diameter >4 cm9.
See also
-<p><strong>Pulmonary arterial aneurysms</strong> refer to a focal dilatation of the pulmonary arterial system.</p><h4>Epidemiology</h4><p>Overall it is considered a rare entity with autopsy prevalence rates of around 1 in 14,000 to 100,000 <sup>4-5</sup>.</p><h4>Pathology</h4><p>A true pulmonary artery aneurysm results from dilatation of all three layers of the vessel wall while a pulmonary artery pseudoaneurysm does not involve all layers of the arterial wall. Most of the aneurysms are central, affecting the main pulmonary arteries <sup>4</sup>.</p><h5>Aetiology</h5><p>The differential for etiologies of pulmonary artery aneurysms can be <a href="/articles/surgical-sieve-mnemonic">broad</a>. Different sources differ as to the most frequent etiologies, likely due to the rarity of the entity and reliance on limited case series.</p><ul>- +<p><strong>Pulmonary arterial aneurysms</strong> refer to a focal dilatation of the pulmonary arterial system.</p><h4>Epidemiology</h4><p>Overall it is considered a rare entity with autopsy prevalence rates of around 1 in 14,000 to 100,000 <sup>4-5</sup>.</p><h4>Pathology</h4><p>A true pulmonary artery aneurysm results from dilatation of all three layers of the vessel wall while a pulmonary artery pseudoaneurysm does not involve all layers of the arterial wall. Most of the aneurysms are central, affecting the main pulmonary arteries <sup>4</sup>.</p><h5>Aetiology</h5><p>The differential for etiologies of pulmonary artery aneurysms can be <a href="/articles/surgical-sieve-mnemonic">broad</a>. Different sources differ as to the most frequent aetiologies, likely due to the rarity of the entity and reliance on limited case series.</p><ul>
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