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A Man in His 20s With Gradually Enlarging Mediastinal Mass and Intermittent Hemoptysis

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1 Credit CME

A man in his 20s with a 2-month history of left chest pain and gradually enlarging mediastinal mass presented with new-onset intermittent hemoptysis. Coronary computed tomography (CT) angiography revealed a giant left anterior descending artery aneurysm surrounded by unenhanced pseudoaneurysm (Figure, A). Findings on the chest CT suggested communication of the partially thrombosed pseudoaneurysm with the adjacent bronchi (Figure, B) given the proximity and associated ground-glass airspace disease, which represented pulmonary hemorrhage and the cause of the intermittent hemoptysis. The patient underwent aneurysm resection and coronary artery bypass grafting. Unfortunately, however, he died of graft dehiscence leading to cardiac tamponade after discharge. It is important to be aware that ruptured coronary artery aneurysm can mimic mediastinal mass,1 a condition that requires timely surgical intervention.

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Article Information

Corresponding Author: Jianqun Yu, MD, Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxuexiang, Chengdu 610041, China (cjr.yujianqun@vip.163.com).

Conflict of Interest Disclosures: None reported.

Reference
1.
Zhang  H , Xiao  Z , Yang  P , Hu  J .  Ruptured coronary artery aneurysm mimicking as a giant mediastinal mass.   Eur Heart J. 2021;42(12):1183. doi:10.1093/eurheartj/ehab018PubMedGoogle ScholarCrossref
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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