case_images: PMC10880485_01
case_images: The chest CT revealed abnormal lesions in the lower lobe of the right lung. (A) In the lung window, a consolidation shadow was observed in the posterior segment of the right lower lobe. (B) In the mediastinal window, the lesion appeared to have regular margins. (C) After contrast enhancement, heterogeneous enhancement was noted within the lesion.
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case_images: PMC10880485_01_fmed-11-1268008-g001.jpg
case_images: fig1
case_images: A chest CT showed a nodular shadow with a relatively regular morphology and uneven enhancement in the right lung (Figure 1).
case_images: The pathological findings of the expectorated mass on HE staining. (A) Dilated and degenerated alveolar contours are visible in the field of view (HE, x40). (B) Interstitial congestion and loss of alveolar epithelial cells can be observed (indicated by red arrows; HE, x100).
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case_images: PMC10880485_01_fmed-11-1268008-g002.jpg
case_images: fig2
case_images: Hematoxylin and eosin (H&E) staining showed degenerated alveolar tissue structure (Figure 2).
case_images: (A,B) The blood supply vascular reconstruction of the lesion reveals a large, tortuous, and malformed artery originating from the descending aorta, extending toward the site of the lesion. (C,D) The upper gastrointestinal (UGI) contrast study. (A) In the axial view, an abnormal communication between the trachea and esophagus is observed. (B) In the coronal view, the contrast agent is seen entering the bronchus through the fistula and remaining within the airway (indicated by a red arrow).
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case_images: PMC10880485_01_fmed-11-1268008-g003.jpg
case_images: fig3
case_images: Body arterial angiography revealed a twisted and deformed artery originating from the thoracic aorta that was supplying blood to the lesion in the right lower lobe of the lung (Figures 3A,B). In addition, upper gastrointestinal (UGI) radiography revealed an abnormal connection between the bronchus and esophagus (Figures 3C,D), so we diagnosed the patient with BPFM.
case_images: The before and after comparison of the arterial embolization treatment for the lesion. (A,C) A consolidation shadow can be seen in the right lung before the treatment. (B,D) After the treatment, the consolidation shadow appears significantly reduced.
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case_images: PMC10880485_01_fmed-11-1268008-g004.jpg
case_images: fig4
case_images: Eighteen months later, a chest CT showed that the lesion had significantly decreased in size and showed local cystic changes (Figure 4).