Abstract

Pulmonary artery pseudoaneurysm (PAP) is a rare vascular phenomenon with a high mortality rate, as these entities can enlarge, rupture, and lead to asphyxiation. It can be congenital or secondary to trauma and infections. This case report highlights a rare cause of PAP in a patient with uncontrolled diabetes.

Case Report:

A 65 year old construction worker who is a diabetic presented with complaints of cough with expectoration and hemoptysis for 20 days. CT thorax showed features of necrotising pneumonia in left lower lobe. Bronchoscopy showed a swelling in the left lower lobe bronchus. CECT Thorax was later done which confirmed descending pulmonary artery pseudoaneurysm. Surgical resection of left lower lobe was done and sent for histopathological examination. Grossly the lobectomy specimen showed a well circumscribed grey brown cavitatory solid and cystic lesion measuring 5.5×4.8×4.4 cm. Microscopy showed necrosis with acute and chronic inflammatory infiltrates and colonies of broad, non-septate, ribbon like fungal hyphae with the morphology consistent with Mucormycosis. Special stains like PAS and GMS highlighted the fungal organism.

Conclusion:

Pulmonary mucormycosis (PM), an underdiagnosed but an increasingly seen entity in the era of chemotherapy and immunosuppression, is a known cause of PAP, and should be suspected in immunosuppressed patients with hemoptysis.