Abhishek Adhikari1, Shahjan Raj
Giri1, Sudhir Yadav1, Roshan
Gami2, Manoj Bist1 and Om Biju
Panta1
1. Department of Radiology, Nepal Mediciti Hospital, Kathmandu, Nepal
2. Tribhuvan University Teaching hospital, Kathmandu, Nepal
Corresponding author: Abhishek Adhikari,
abhishek09iom@gmail.com
Supervisor: Om Biju panta,
bijupanta@yahoo.com
Consent:
Written informed consent was obtained from the patient to publish this
report in accordance with the journal’s patient consent policy.
Abstract:
This case report describes a 41-year-old male patient whose screening
chest X-ray revealed irregular tubular radio dense opacities in the
right hilar region, suggestive of a vascular lesion. Subsequently, CT
angiogram of the chest revealed a congenital bronchial artery-pulmonary
artery fistula. Despite being informed about the diagnosis and available
treatment options, the patient refused treatment and wanted to be on
regular follow-up. This case highlights the importance of thorough
imaging evaluation in diagnosing rare vascular abnormalities and
explores the existing gap in literates regarding treatment in
asymptomatic patients.
Key words
Bronchial-pulmonary artery, Arteriovenous malformation, CT angiography,
Asymptomatic.
Introduction:
Abnormal communication between a systemic artery and pulmonary artery is
a rare anomaly which may be congenital or acquired. The acquired causes
of such malformations are inflammatory or infective lung disease,
penetrating trauma, or tumor (2). Here we describe a primary anomalous
communication between a dilated convoluted bronchial artery and the
branch of the pulmonary artery incidentally found on a routine health
checkup radiograph. Such communications have been given various names in
the literature, one commonly used name being the racemose hemangioma of
the bronchial artery (7).
Case Report.
A 41-year-old male patient came for a screening chest X-ray. He had no
complaints. No history of fever, vomiting, and cough. No previous
medical and surgical history was noted. Physical and clinical
examination revealed no gross abnormalities. Chest X-ray PA view (Figure
1) demonstrated irregular tubular radiodense opacities on the right
hilar region. Both lung fields were normal with normal broncho-vascular
markings. A diagnosis of some form of vascular lesion was made and the
patient was advised a CT angiogram chest.