伴肺动脉瘤破裂的白塞综合征

Behcet’s disease complicated with rupture of pulmonary aneurysm

报告1例白塞综合征并发肺动脉瘤破裂。患者男,29岁。因咳嗽、咯血1年余,加重1个月入院。肺动脉CT血管造影(CTA)检查:双肺动脉及其分支多数被周围软组织影包绕,并左上舌段、左下肺动脉分支截断,右肺中叶动脉中段扩张、远段截断及以远带状软组织密度影,左肺下叶前基底段肺动脉外形不规则。左肺下叶后基底段胸膜下楔形软组织密度影。考虑肺动脉血管炎,结合既往有口腔、外阴反复溃疡史2年,针刺反应(+),胸部、背部及下肢可见散在毛囊性脓疱样疹,诊断为白塞综合征(多系统损害);右肺肺动脉瘤并大咯血。

A case of Behcet’s disease complicated with rupture of pulmonary aneurysm is reported. A 29-year-old man was admitted to hospital because of cough and hemoptysis for over a year, aggravated for 1 month. Pulmonary artery CTA showed most of the pulmonary arteries and their branches surrounded by soft tissue, ruptured left upper lingular artery and left lower pulmonary artery, and dilated middle segment of the right middle lung artery, ruptured distal segment, and a band appearing in the density of soft tissue. The left inferior anterior basilar artery was irregular. The mediastinal pleura of the left inferior posterior basilar segment also displayed a density of soft tissue, suggesting the presence of pulmonary artery vasculitis.Together with a 2-year history of recurrent oral and vulvar ulcers, acupuncture reaction(+), scattered follicular pustule-like eruptions on the chest, back and lower limbs, a diagnosis of Behcet’s disease(multisystem damage) complicated with right pulmonary aneurysm and hemoptysis was made.