SummaryBackgroundBronchial artery aneurysm (BAA) is a rare condition with a reported prevalence of less than 1% of all selective bronchial arterial angiograms. Despite its low incidence, BAA represents a potential cause of hemoptysis.Case ReportWe describe the case of a 63-year-old man suffering from chronic obstructive pulmonary disease (COPD), who presented with non-massive hemoptysis.CT angiography revealed a single bronchial artery aneurysm of 9 mm in diameter, abutting the esophageal wall.Other CT findings included hypertrophy of the bronchial arteries along the mediastinal course, diffuse thickening of the walls of numerous bronchial branches and a “ground glass” opacity in the anterior segment of the right upper pulmonary lobe suggestive of alveolar hemorrhage.The final diagnosis was established based on selective angiography, which was followed by transcatheter arterial embolization (TAE) of the BAA and of the pathological bronchial circulation.Follow-up CT scans revealed a total exclusion of the aneurysm from the systemic circulation, resolution of the parenchymal “ground glass” opacity and absence of further episodes of hemoptysis over a period of two years.ConclusionsAn incidental finding of a bronchial artery aneurysm necessitates prompt treatment.CT angiography and TAE represent the methods of choice for an appropriate diagnosis and treatment, respectively.In case of a BAA associated with chronic inflammatory diseases, such as COPD, in patients with hemoptysis, TAE of the BAA and of the pathological bronchial circulation, in association with the treatment of the underlying disease, represents a valid approach that can improve the pulmonary status and prevent further episodes of hemoptysis.

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Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease that involves collagen tissue throughout the body. Several previous studies have shown that the risk of ischaemic and haemorrhagic stroke is significantly higher in SLE when compared to the general population, particularly in young individuals, representing one of the principal causes of death in these patients. Though the precise pathophysiology behind this increased risk is still poorly understood, several mechanisms are suggested to play a role. The high burden of cerebral small vessel disease features noted on brain neuroimaging studies, as well as the accelerated process of atherosclerosis identified in these patients, are likely to be responsible for at least some of the ischaemic strokes occurring in the SLE population. Repeated episodes of arterial and venous thrombosis secondary to antiphospholipid syndrome are likewise important. Less is known regarding the exact pathophysiological relationship between SLE and the high incidence of haemorrhagic stroke, though thrombocytopenia and a greater susceptibility to form typical and atypical brain aneurysms, which may then rupture, are thought to be the main mechanisms responsible for the occurrence of intracerebral and subarachnoid haemorrhage, respectively. Both inflammatory and noninflammatory events, all involving the immune system, are responsible for several pathological changes affecting cerebral vessels of every calibre in SLE, as confirmed by histopathology. In this context, endothelial activation and dysfunction play a critical role. This review will briefly analyse the most important factors responsible for the higher ischaemic and haemorrhagic stroke risk in the SLE population, with a particular focus on brain vascular changes.

Estimating early postmortem interval (EPI) is a difficult task in daily forensic activity due to limitations of accurate and reliable methods. The aim of the present work is to describe a novel approach in the estimation of epi based on quantitative magnetic resonance molecular imaging (qMRMi) using a pig phantom since post-mortem degradation of pig meat is similar to that of human muscles. on a pig phantom maintained at 20° degree, using a 1.5 T MRI scanner we performed 10 scans (every 4 hours) monitoring apparent diffusion coefficient (ADC), fractional anisotropy (FA) magnetization transfer ration (MTR), tractography and susceptibility weighted changes in muscles until 36 hours after death. cooling of the phantom during the experiment was recorded. Histology was also obtained. pearson's test was carried out for time correlation between post-mortem interval and MRi data. We found a significative inverse correlation between ADC, FA, MT values and PMI. Our preliminary data shows that post-mortem qMRMi is a potential powerful tool in accurately determining epi and is worth of further investigation.