Kosin Med J.  2021 Dec;36(2):136-143. 10.7180/kmj.2021.36.2.136.

Rasmussen’s Aneurysm, Rare yet Acknowledged Cause of Massive Hemoptysis: Retrospective Review of 16 Cases

• Chung S
• Heo IR
• Kim TH
• Ju SM
• Yoo JW
• Lee SJ
• Cho YJ
• Park SU
• Jeon KN
• Kim HC

• KMID: 2524652
• DOI: http://doi.org/10.7180/kmj.2021.36.2.136

Abstract

Objectives
Rasmussen’s aneurysm may cause life-threatening hemoptysis. We investigated the clinical characteristics and outcomes of patients with hemoptysis and Rasmussen’s aneurysm.
Methods
We retrospectively investigated patients who clinically presented with hemoptysis and were diagnosed with a Rasmussen’s aneurysm on spiral chest computed tomography (CT).
Results
Our study included 16 patients (men:women, 12:4; mean age, 65.25 ± 13.0 years). Massive hemoptysis was observed in nine patients (56%) and blood-tinged sputum in four patients (25%). Ten patients (62.5%) had a history of pulmonary tuberculosis, and three patients (18.7%) had underlying lung cancer. Chest CT revealed coexisting fungal balls in seven patients (43.7%). Bronchial artery embolization (BAE) was performed in 12 patients (75%). One patient died of uncontrolled massive hemoptysis.
Conclusions
Patients with Rasmussen’s aneurysm showed hemoptysis during the course of the disease; however, bleeding can be controlled with conservative therapy and radiological interventions, such as BAE.

Keyword

Embolization; Hemoptysis; Rasmussen’s aneurysm

Figure

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  Fig. 1 A 59-year-old man presented with massive hemoptysis amounting to approximately 100 cc. (A) Chest X-ray showing volume loss in the right lung with a cavitary lesion in the upper lobe. A calcified lesion in the field of the left upper lobe represents the previous history of pulmonary tuberculosis. (B) Enhanced chest CT scan showing cavitary lesion with sponge-like soft tissue in the collapsed right upper lobe. A focal aneurysm in the area adjacent to the cavitary lesion represents Rasmussen’s aneurysm.

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  Fig. 2 An 82-year-old man with lung cancer complained of hemoptysis for 3 days. (A) Chest X-ray showing dense a consolidative lesion in the left upper lobe with an air-space lesion. (B) Enhanced chest CT scan showing diffuse consolidation and necrotic change in the left upper lobe and formation of Rasmussen’s aneurysm in the necrotic and consolidative lesion. (C) The angiographic finding was a large aneurysm in the left pulmonary artery branch.

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