Rasmussen-Aneurysma
nicht verwechseln mit: Rasmussen-EnzephalitisRasmussen aneurysm (not to be confused with Rasmussen encephalitis) is an uncommon complication of pulmonary tuberculosis and represents a pulmonary artery aneurysm adjacent or within a tuberculous cavity.
Epidemiology
It can be present in up to 5% of patients with chronic cavitary tuberculosis on autopsy.
Clinical presentation
Hemoptysis is the usual presenting symptom and may be life-threatening when it is massive.
Pathology
A weakening of the pulmonary artery wall from adjacent cavitary tuberculosis is the cause of this condition: there is a progressive weakening of the arterial wall as granulation tissue replaces both the adventitia and the media. This is then gradually replaced by fibrin, resulting in thinning of the arterial wall, pseudoaneurysm formation, and subsequent rupture with hemorrhage.
Location
Usually distributed peripherally and beyond the branches of the main pulmonary arteries .
Radiographic features
CT
CT pulmonary angiography is the investigation of choice . Often seen on contrasted chest images as a focal dilatation of one of the pulmonary segmentary arteries adjacent to tuberculous parenchymal change or a chronic tuberculous cavity.
History and etymology
It is named after Danish physician Fritz Valdemar Rasmussen (1837-1877).
Differential diagnosis
It is almost pathognomonic if present in the right clinical content and in the vicinity of a tuberculous cavity.
In atypical cases consider:
- vasculitis (can be an aneurysm or pseudoaneurysm)
- pulmonary artery pseudoaneurysm -
- iatrogenic, e.g. injury from a Swan-Ganz catheter
- mycotic aneurysm: especially if in intravenous drug users
Siehe auch:
- pulmonale Tuberkulose
- Morbus Behçet
- mykotisches (infiziertes) Aneurysma
- Kavernöse Lungenläsionen
- Hughes-Stovin-Syndrom
- Rasmussen-Enzephalitis
- Aneurysma der Arteria pulmonalis
und weiter:
Assoziationen und Differentialdiagnosen zu Rasmussen-Aneurysma:
