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Jung, Lim, Chun, Suh, Kim, Lee, Park, Kim, Chang, Kim, and Kim: A Case of Video-Assisted Thoracoscopic Pneumonectomy for Unilateral Diffuse Pulmonary Arteriovenous Malformation
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2006; 61(6): 585-590.

Published online: 30 December 2006

DOI: https://doi.org/10.4046/trd.2006.61.6.585

A Case of Video-Assisted Thoracoscopic Pneumonectomy for Unilateral Diffuse Pulmonary Arteriovenous Malformation

Jong Yul Jung, M.D.1, Jong Keun Lim, M.D.1, Sung Wan Chun, M.D.1, Won Na Suh, M.D.1, Dae Jun Kim, M.D.2, Kwang Hun Lee, M.D.3, Moo Suk Park, M.D.1, Se Kyu Kim, M.D.1, 4, Joon Chang, M.D.1, 4, Sung Kyu Kim, M.D.1, 4, Young Sam Kim, M.D.1, 4

1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

2Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Korea.

3Department of Diagnostic Radiology, Yonsei University College of Medicine, Seoul, Korea.

4The Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea.

Address for correspondence: Young Sam Kim, M.D. Department of Internal Medicine, Yonsei University College of Medicine, 134 Shinchon-Dong, Seodaemun-Ku, Seoul 120-752, South Korea. Phone: 82-2-2228-1965, Fax: 82-2-393-6884, ysamkim@yumc.yonsei.ac.kr

Received 16 October 2006       Accepted 6 November 2006

Copyright © 2006 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Pulmonary arteriovenous malformations (PAVMs) are abnormal direct communications between the pulmonary arteries and veins. PAVMs may occur as either an isolated abnormality or in association with hereditary hemorrhagic telangiectasia, also called Osler-Weber-Rendu disease. The topic of PAVM has recently been extensively reviewed, but little is known about the clinical characteristics and course of patients having a diffuse pattern of the disease. Herein, is reported a case of unilateral diffuse PAVM in an 18 year old female patient, who underwent a right pneumonectomy, under a video-assisted thoracic surgery (VATS) approach, as the diffuse small pulmonary arteriovenous malformation involved the whole right lung.

Keywords: Diffuse, Pulmonary, Arteriovenous malformation

Figures and Tables

Figure 1
Chest roentgenogram showed minimal parenchymal infiltration on right parahilar area at admission.
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Figure 2
Chest CT scan showed slightly dilated tortuous pulmonary arteries and pulmonary veins (long arrow) in right segment 1, 2, 3, 6, 7, 8, 9, 10. Hypertrophied bronchial arteries and mediastinal collaterals through right pulmonary ligament.
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Figure 3
Main pulmonary arteriography showed innumerable tiny saccular aneurysms on the whole right pulmonary artery peripheral portion and early venous drainage (A). Selective right interlobar pulmonary artery and upper lobar pulmonary artery angiography demonstrated innumerable tiny saccular aneurysms and early venous drainage (B).
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Figure 4
3-Dimentionally reconstructed CT scan showed diffuse pulmonary arteriovenous malformations on the right Lung.(A) Magnified Image of the right Lung (B)
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Figure 5
The specimen showed geographic hemorrhage in the superior segment of lower lobe. On section, multiple dilated blood vessels and multifocal hemorrhage are noted
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Table 1
Characteristics of patients with diffuse pulmonary AVMs*
trd-61-585-i001

*AVMs : arteriovenous malformations

†NA : Not available

‡TIA : Transient ischemic attack

§PFR: Pulmonary flow redistribution

References

1. Gossage JR, Kanj G. Pulmonary arteriovenous malformations: a state of the art review. Am J Respir Crit Care Med. 1998. 158:643–661.
2. Vase P, Holm M, Arendrup H. Pulmonary arteriovenous fistulas in hereditary hemorrhagic telangiectasia. Acta Med Scand. 1985. 218:105–109.
3. Hodgson CH, Burchell HB, Good CA, Claggett OT. Hereditary hemorrhagic telangiectasis and pulmonary arteriovenous fistula. N Engl J Med. 1959. 261:625–636.
4. Ahn JB, Kim IS, Jung SC, Kim WS, Shin YC, Yoo HK, et al. Pulmonary arteriovenous fistula with hemothorax. Korean J Thorac Cardiovasc Surg. 2004. 37:702–706.
5. Cottin V, Plauchu H, Bayle JY, Barthelet M, Revel D, Cordier JF. Pulmonary arteriovenous malformations in patients with hereditary hemorrhagic telangiectasia. Am J Respir Crit Care Med. 2004. 169:994–1000.
6. Dines DE, Arms RA, Bernatz PE, Games MR. Pulmonaryarteriovenous fistulas. Mayo Clin Proc. 1974. 49:460–465.
7. White RI Jr, Lynch-Nylan A, Terry P, Buescher PC, Farmlett EJ, Charnas L, et al. Pulmonary arteriovenous malformations: techniques and long-term outcome of embolotherapy. Radiology. 1988. 169:663–669.
8. Shannon T, Pollak J, White RI. Redistribution of pulmonary blood flow by embolotherapy: a new method for improving oxygenation in patients with diffuse pulmonary arteriovenous malformations [Abstract]. Am Rev Respir Dis. 1992. 145:600A.
9. Hepburn J, Dauphinee JA. Successful removal of hemangioma of lung followed by disappearance of polycythemia. Am J Med Sci. 1942. 204:681–687.
10. Wallenhaupt SL, D'Souza V. Combined radiological and surgical management of arteriovenous malformation of the lung. Ann Thorac Surg. 1988. 45:213–215.
11. Temes RT, Paramsothy P, Endara SA, Wernly JA. Resection of a solitary pulmonary arteriovenous malformation by video-assisted thoracic surgery. J Thorac Cardiovasc Surg. 1998. 116:878–879.
12. Thung KH, Sihoe AD, Wan IY, Lee TW, Wong R, Yim AP. Hemoptysis from an unusual pulmonary arteriovenous malformation. Ann Thorac Surg. 2003. 76:1730–1733.
13. Frughnan ME, Lui YW, Wirth JA, Pugash RA, Redelmeier DA, Hyland RH, et al. Diffuse pulmonary arteriovenous malformations: charecteristics and prognosis. Chest. 2000. 117:31–38.
14. Jeong WK, Jeon SC, Choi YW, Park CK, Hong EK, Yoon HJ, et al. Telangiectatic pulmonary arteriovenous malformation. J Thorac Imaging. 2003. 18:113–115.
15. Jeon YB, Lee JK, Kim JH, Lee DC, Kim DS. Two cases of diffuse type of pulmonary arteriovenous fistula. Korean J Med. 1986. 30:555–561.
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