SPONTANEOUS PULMONARY HEMATOMA: A CASE REPORT

TOPIC: Lung Pathology TYPE: Medical Student/Resident Case Reports INTRODUCTION: Pulmonary hematoma is a known possible sequela of blunt or indirect trauma to the thorax. However, only couple cases were reported where pulmonary had formed spontaneously without an underlying etiology. Imaging frequently misleads towards malignancy even cavitation, posing difficulties in diagnosis especially with unremarkable medical history. CASE PRESENTATION: We report 44-year-old male who presented ED chief complaint sudden onset bloody sputum preceded by one-week history dry cough. A CT chest was obtained which revealed large left lower lobe mass extension into medial bronchus, prominent infrahilar lymph nodes, and area nodular dense lung consolidation lobe.The surgery team consulted. The patient underwent thoracotomy lobectomy 6.8 x 7.0 6.5 cm mass. Histopathological examination resected specimen parenchymal hemorrhagic necrosis parenchyma intra-alveolar hemorrhage malignancy. uneventful post-operative course complete resolution his hemoptysis. DISCUSSION: pathological mechanism spontaneous remains unclear. Some authors have suggested that bleeding could occur pre-existing bullae cysts. Others it starts off as followed secondary infection eventually leads angionecrosis further promotes newly Radiological findings are non-specific can often masquerade metastatic carcinoma.It present on nodules masses thus difficulty distinguishing from cancer. high density lesion scan help making there very few causes high-density non-calcified lesions. In case asymptomatic incidental finding, will disappear between three weeks months management would be conservative. Further work-up evaluation possibility for necessary if opacity has increased size follow-up exams. Additionally, MRI been shown aid particularly distinguish exclusion should considered malignant negative. CONCLUSIONS: When observed, clinicians consider hematoma, no symptoms exist.The these patients sometimes pose challenge disclosure rare may improve knowledge about best therapeutic strategy. REFERENCE #1: Dekeyzer S, De Kock I, Smet B, Van Meerbeeck S. presenting pseudotumor. JBR-BTR. 2013;96(6):399. doi:10.5334/jbr-btr.534 #2: Tamura Y, Kushibe K, Tojo T, Takahama M, Kimura Taniguchi SJpn J Thorac Cardiovasc Surg. 2006 Oct; 54(10):437-9 #3: Fukuyama Aizawa H, Inoue Hidaka Murayama Murakami J, Hara N. Intrapulmonary diagnosed magnetic resonance imaging. Jpn Dis. 1997;35:245–249 DISCLOSURES: No relevant relationships Sukaina Alikhan, source=Web Response Azzan Arif, Nadia Kamagate, Jawad Shabani,