A 69 year old woman was referred to hospital because of a persistent dry cough and dyspnoea. She has never smoked and was taking captopril for hypertension and thyroxine for hypothyroidism. At age 20 she developed pulmonary tuberculosis which was treated with a left artificial pneumothorax. A few years later during the course of investigation into infertility she was found to have tuberculous endometriosis and salpingitis. This was treated with streptomycin injections and isoniazid.A large mass measuring 10 cm × 9 cm was seen on chest radiography (see figs 1 and 2). Computed tomography of the thorax demonstrated a solid, partially calcified 10 cm mass situated posteriorly in the left upper lobe. In addition there was loss of volume and concentric pleural thickening in the left hemithorax, probably as a result of the previous artificial pneumothorax. No metastases were evident. At bronchoscopy irregular mucosa was noted in the left upper lobe bronchus. A biopsy specimen of this showed abnormal lymphoid tissue. Staining of sputum for acid-alcohol fast bacilli and subsequent mycobacterial cultures were negative.In the meantime the patient had developed marked hypertension, spontaneous bruising, and epistaxis. Fundal haemorrhages were present. Blood tests revealed a plasma viscosity of 5.3 mpa/s (normal range 1.5-1.72), haemoglobin

Gastric ulcer and its complications are commonly encountered by physicians. Penetration is only noted in about 20% of the cases. Penetration into the splenic artery is a very rare occurrence. Making the diagnosis early on is important in order to prevent morbidity and mortality due to the brisk bleeding that can follow. In our report we describe the case, the imaging and the interventional radiological findings which helped with management. We review the literature published including radiological findings in such cases and describe the proposed pathogenesis. Definitive treatment usually involves controlling the bleeding either by means of embolization using coils or ligating the bleeding vessel.