Rasmussen’s aneurysm masquerading as mass lesion

Abstract

Haemoptysis is an often encountered respiratory symptom. The amount of haemoptysis varies from mild to life-threatening severity and may indicate the underlying pulmonary disorder. Herein, we report a 50-year-old male smoker who presented with occasional streaky to mild haemoptysis for last 1 year. He had pulmonary tuberculosis 10 years ago and had received adequate treatment. Chest radiograph was suspicious of a mass lesion in left upper lung. Contrast-enhanced CT scan of thorax revealed pulmonary artery pseudoaneurysm suggestive of Rasmussen’s aneurysm. Unlike this case, Rasmussen’s aneurysm usually manifests as life-threatening haemoptysis and portends a high mortality.

Rasmussen aneurysm: Case series of a rare complication of Pulmonary Tuberculosis

“…Communication of broncho-pulmonary and arterio-venous are at risk to rupture in the form of pseudoaneurysm formation, therefore combined embolization via the bronchial and pulmonary arteries is required to prevent recurrent haemoptysis [ 14 , 15 ]. Mild to moderate haemoptysis can be controlled by antitubercular therapy, however massive haemoptysis needs urgent intervention [ 16 , 17 ]. Massive haemoptysis in pulmonary tuberculosis can present as a result of multiple underlying secondary pathologies like bronchiectasis, aspergilloma, broncholiths or vascular complications [ 16 ].…”

Massive Hemoptysis in Pulmonary Tuberculosis From Rasmussen Pseudoaneurysm

“…This highlights the severity of massive hemoptysis caused by Rasmussen aneurysm. On the other hand, there was another case from India in 2020 that had a more fortunate course, as it only presented with mild hemoptysis and did not progress further [7]. A 45-year-old Indian male, with type 2 diabetes mellitus and chronic kidney disease, was admitted to the medical ward as a case of pulmonary tuberculosis based on a positive acid-fast bacilli sputum sample and a chest X-ray finding of a large left-sided pleural effusion with collapsed consolidation of the left lung lower lobe.…”