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Vol. 57. Issue 9.
Pages 588 (September 2021)
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Vol. 57. Issue 9.
Pages 588 (September 2021)
Clinical Image
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Pulmonary Artery Aneurysm Partially Regressing With Medical Treatment in Behçet's Disease
Aneurisma de la arteria pulmonar con regresión parcial tras tratamiento médico en la enfermedad de Behçet
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Veysel Ayyildiza, Yener Aydinb, Hayri Ogulc,
Corresponding author
drhogul@gmail.com

Corresponding author.
a Department of Radiology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
b Department of Thoracic Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
c Department of Radiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
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A 40-year-old male with Behcet's disease presented with complaints of cough, dyspnea, and intermittent hemoptysis. Maximum intensity projection (MIP) thorax computed tomography (CT) angiography scans revealed aneurysms in the anterior and posterior segmentary pulmonary arteries of the right upper lobe (Fig. 1A and C). Corticosteroids and intravenous cyclophosphamide treatment was applied to the patient. In control examination after eight months, thorax CT angiography scans showed complete resolution of the aneurysm in the posterior segmentary pulmonary artery of the right upper lobe (Fig. 1B and D). Aneurysm in the anterior segmentary pulmonary artery showed persistently in CT angiographic images. In presentation and control examination, anterior view 3D volume rendering CT images revealed clearly persistent and shrinking aneurysms (Fig. 1E and F).

Fig. 1.

In presentation, coronal (A) and axial (C) MIP thorax CT angiography scans reveal aneurysms in the anterior (frame) and posterior (arrow) segmentary pulmonary arteries of the right upper lobe. In control examination eight months after corticosteroid and intravenous cyclophosphamide treatment, coronal (B) and axial (D) MIP thorax CT angiography scans show complete resolution (arrow) of the aneurysm in the posterior segmentary pulmonary artery of the right upper lobe. Aneurysm (frame) in the anterior segmentary pulmonary artery shows persistently in CT angiographic images. In presentation (E) and control examination (F), anterior view 3D volume rendering CT images reveal clearly persistent (asterisk) and shrinking (arrow) aneurysms.

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Behçet's disease may cause pulmonary artery aneurysm. This complication is usually seen in men and can be fatal. Pulmonary artery involvement is seen in 10% of patients with Behçet's disease.1,2 Medical treatment with corticosteroids and cyclophosphamide showed an improvement of approximately 40–80% in 5-year survival.2 If medical treatment is insufficient, surgical or interventional radiology treatments should be considered. Pulmonary artery aneurysm should be kept in mind in patients with Behçet's disease presenting with hemoptysis.

References
[1]
S. Yilmaz, K.A. Cimen.
Pulmonary artery aneurysms in Behçet's disease.
Rheumatol Int, 30 (2010), pp. 1401-1403
[2]
H. Kage, Y. Goto, Y. Amano, K. Makita, H. Isago, K. Kobayashi, et al.
Development of pulmonary artery aneurysms due to Behçet's disease and resolution after treatment.
Intern Med, 55 (2016), pp. 3337-3340
Copyright © 2020. SEPAR
Archivos de Bronconeumología

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