Arterio-Venous Aneurysma of the Lung

1) In a 48 year old male with cyanosis and clubbing of the fingers and a murmur over the base of the left lung the diagnosis of an arteriovenous aneurysm was made clinically. The diagnosis was confirmed by x-ray examination and planigraphy which showed a vascular loop in the left lower lobe. The patient died of brain abscess and the aneurysm was demonstrated by injection with polyvenylacetic esters.

2) A review is given of the cases reported to-date (Table 1) with their chief clinical characteristics. Cases without cyanosis may be explained by the existence of a fistula between a bronchial artery and a pulmonary vein.

3) The most serious complication is rupture of the aneurysmal sack into a bronchus or into the pleural space. Neurological symptoms are common. These patients seem to have poor resistance against infections. Four of the cases died of brain abscess.

4) In spite of the characteristic clinical picture, x-ray examination is of the utmost importance for the diagnosis, and before surgical intervention angiography ought to be done because of the frequent multiplicity of the lesion.