case_images: PMC10766742_01
case_images: Fig. 1 Preoperative contrast-enhanced CT image. (A) PDA aneurysm compressing on the esophagus, and the aortic side orifice (white arrow) with a diameter of 14 mm. (B) The aneurysm located under the aortic arch and aneurysmal sac measured 57 x 50 mm. It exerted pressure on the esophagus (black arrow, blue colored: esophagus). (C) The pulmonary side orifice (black arrow) with a diameter of just 4 mm. CT: computed tomography; PDA: patent ductus arteriosus.
case_images: avd-16-265-g001.jpg
case_images: PMC10766742_01_avd-16-265-g001.jpg
case_images: figure1
case_images: A 55-year-old man presented with severe dysphagia, and a contrast-enhanced computed tomography (CT) revealed a PDA aneurysm that was compressing the esophagus (Fig. 1A). The orifice in the aorta was 14 mm in diameter (Fig. 1A); the aneurysmal sac measured 57 x 50 mm, which was compressing the esophagus (Fig. 1B); and the PA orifice was 4 mm in diameter (Fig. 1C).
case_images: Fig. 2 Histology of aneurysmal wall. (A) Elastica-Masson stain, (B) immunohistochemistry for alpha-SMA, and (C) H&E stain. The arrow indicates a tiny mass of cystic medial necrosis (C). Bars represent 250 mum. SMA: smooth muscle actin; H&E: hematoxylin and eosin; I: intima; M: media.
case_images: avd-16-265-g002.jpg
case_images: PMC10766742_01_avd-16-265-g002.jpg
case_images: figure2
case_images: During the pathological examination, the aneurysmal wall showed mild thickening of the intima and media without atherosclerotic changes (Fig. 2). Smooth muscle cells were densely arranged in the media and appeared to be hyperplastic (Figs. 2A and 2B). A tiny mass of cystic medial necrosis was found in the media (Fig. 2C).