Left hilar mass with obstruction of the main bronchus due to localized pseudoaneurysm of the thoracic aorta
Lukanich, J.M.; Conlan, A.A.
Canadian Journal of Surgery. Journal Canadien de Chirurgie 39(1): 63-66
1996
ISSN/ISBN: 0008-428X PMID: 8599796 Document Number: 455212
The left hilum is an anatomically complex region. It is poorly imaged on conventional chest roentgenography and even on tomography. A wide range of diagnoses must be considered upon discovery of a hilar mass. In this report, the authors discuss their experience with a potentially hazardous hilar mass found in a 61-year-old man with a 40 pack-year smoking history. The mass, which was identified as an aortic pseudoaneurysm, caused near-total obstruction of the left main bronchus. The aneurysm was successfully repaired and patency of the bronchus restored. Radiographic features that suggest an aortic aneurysm as a cause of a hilar mass include posterior location and lack of associated mediastinal or contralateral hilar adenopathy. Computer tomography with contrast will readily define a vascular hilar mass. If cancer or lymphoma are suspected as the cause of a hilar mass, mediastinal lymph-node imaging, and aspiration or biopsy are indicated.