Journal List > Tuberc Respir Dis > v.64(1) > 1001217

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Lee, Kim, Kang, Park, Lee, Kim, Lee, and Jeong: A Case of Pulmonary Arterial Thrombosis in a Patient with Tuberculous-destroyed Lung and Pulmonary Hypertension
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2008; 64(1): 28-32.

Published online: 31 January 2008

DOI: https://doi.org/10.4046/trd.2008.64.1.28

A Case of Pulmonary Arterial Thrombosis in a Patient with Tuberculous-destroyed Lung and Pulmonary Hypertension

Ji Eun Lee, M.D.1, Jung Hyun Kim, M.D.1, Min Kyoung Kang, M.D.1, Hyun Jeong Park, M.D.1, Ji Hyun Lee, M.D., Ph.D.1, Eun Kyung Kim, M.D., Ph.D.1, Young Kyung Lee, M.D., Ph.D.2, Hye Cheol Jeong, M.D., Ph.D.1

1Department of Internal Medicine, Pochon CHA University College of Medicine, Seongnam, Korea.

2Department of Radiology, Pochon CHA University College of Medicine, Seongnam, Korea.

Address for correspondence: Hye Cheol Jeong, M.D., Ph.D. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Bundang CHA Hospital, Pochon CHA University, 351, Yatap-dong, Bundang-gu, Seongnam 463-712, Korea. Phone: 82-31-780-6142, Fax: 82-31-780-4800, jhcmd@hanmail.net

Received 15 November 2007       Accepted 15 January 2008

Copyright © 2008 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Pulmonary arterial thrombosis develops during hypercoagulable states, intra-arterial tumorous conditions, and congenital heart disease accompanied by pulmonary hypertension. Thrombosis in the main pulmonary arterial stump after pneumonectomy can also occur. Herein, we report a very rare case of pulmonary arterial thrombosis in a patient with pulmonary hypertension and a lung destroyed by tuberculosis. He presented with aggravated dyspnea without fever or purulent sputum. His chest computerized tomography scan showed left main pulmonary arterial thrombosis as a convex shape, with the ipsilateral distal arteries and arterioles showing parenchymal destruction. After excluding pulmonary thromboembolism and hypercoagulable disorders, we diagnosed pulmonary arterial thrombosis and treated him with an anticoagulant.

Keywords: Pulmonary arterial thrombosis, Tuberculous-destroyed lung, Pulmonary hypertension

Figures and Tables

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Figure 1
Chest X-ray on the first day at the hospital shows increased opacity in left lung with traction bronchiectasis and multiple calcified nodules.

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Figure 2
Lung setting of chest CT shows decreased lung volume, bullous emphysema, traction bronchiectasis, architectural distortion and multiple small calcifications in right upper lobe, superior segment of right lower lobe and left lung.

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Figure 3
Contrast enhanced chest CT on the first day shows focal filling defect with convex-shape thrombus in left main pulmonary artery.

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Figure 4
Contrast enhanced chest CT after anticoagulation for 2 weeks shows decreased size of thrombus in left main pulmonary artery.

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