Question:

Which of the following are true regarding hemoptysis in a case of absent pulmonary artery?
1. It is uncommon
2. It is usually due to infection
3. Lobectomy is a treatment option
4. There is no role for selective embolization due to there being no pulmonary artery
5. Pulmonary venous wedge angiography is required before surgery





Answer:

The correct answers for the question "Which of the following are true regarding hemoptysis in a case of absent pulmonary artery?" are:

3. Lobectomy is a treatment option

5. Pulmonary venous wedge angiography is required before surgery



Explanation
1.    Hemoptysis is one of the common presentations, occurring in up to 20% of symptomatic cases. [Common presentations include shortness of breath, recurrent pulmonary infections and hemoptysis]

2.    It is usually due to increased pressure in bronchial arteries that have hypertrophied to meet the vascular demands of the lung [The cases which present with hemoptysis are thought to be due to the high arterial pressure in the collaterals from bronchial arterioles and venules].

3.    Lobectomy is one of the proven effective treatment methods. [Treatment options for massive hemoptysis and intractable life-threatening pulmonary infections include pneumonectomy and lobectomy].

4.    Hemoptysis occurs from bronchial arterial collaterals, not from the pulmonary artery [selective embolization of hypertrophied bronchial arteries may control hemoptysis successfully].

5.    Pulmonary venous wedge angiography is required before revascularization to delineate the arterial anatomy at the lung hilum [Pulmonary venous wedge angiography is particularly useful in delineating the presence of an ipsilateral hilar pulmonary artery and intrapulmonary vessels, which is required before revascularization.]



From the manuscript:
Incidentally detected unilateral pulmonary artery agenesis with pulmonary hypoplasia in a 67 year old woman
Radiology Case. 2010 Nov; 4(11):32-37


This article belongs to the Chest section.




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From the manuscript

Incidentally detected unilateral pulmonary artery agenesis with pulmonary hypoplasia in a 67 year old woman

Free full text article: Incidentally detected unilateral pulmonary artery agenesis with pulmonary hypoplasia in a 67 year old woman

Abstract
Unilateral pulmonary artery agenesis is commonly seen associated with other congenital cardiovascular defects, when it is detected early in life, but isolated absence of the pulmonary artery is a rare entity, usually detected in adulthood. The latter patients are usually asymptomatic or might present with varied non-specific manifestations such as respiratory tract infections and hemoptysis. This report describes the imaging findings of a 67 year old female with absence of the right pulmonary artery. The embryology and clinical manifestations of the condition are reviewed.






References



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