A case of pulmonary arteriovenous malformation having difficulty in differential diagnosis of the hemoptysis during each menstrual period
Yutaka Takahara Ryo Kato Ken Nakagawa Shiro Mizuno Kazuhiro Osanai Hirohisa Toga
Department of Respiratory Medicine, Kanazawa Medical University
A 28-year-old woman was admitted to our hospital because of recurrent hemoptysis during her menstrual period in the past three months. Chest CT images showed a ground-glass opacity in left lung S8 and a pulmonary arteriovenous malformation (PAVM) in left lung S6. Bronchoscopic examination performed during her menstruation and dilatation of submucosal vessels was observed in the lower trachea and bilateral main bronchus. A bronchoalveolar lavage fluid from the left B8 showed fresh bloody fluid containing hemosiderin-laden macrophages; therefore clinically a diagnosis of pulmonary endometriosis was suspected. Antiandrogen therapy using a gonadotropin-releasing hormone agonist was applied and improved her hemoptysis. We also performed a transcatheter coil embolization for the PAVM. After this treatment, her clinical state has been stable without recurrence for 5 years. We report a case of recurrent hemoptysis during each menstrual period with pulmonary arteriovenous malformation for the first time in Japan, which was treated with a minimal invasive technique.
Hemoptysis Pulmonary endometriosis Pulmonary arteriovenous malformation
Received 12 Aug 2016 / Accepted 17 Jan 2017
AJRS, 6(3): 215-219, 2017