Sang Yong Park 1, Ho Cheol Kim 2, Seongbong Wee 1, Yeon Joo Kim 2, Chae-Man Lim 2, Yong-Gil Kim 3, Geun Dong Lee 4, Seungjoo Lee 5, Hee Sang Hwang 6, Se Jin Jang 6, Beom Hee Lee 7, Won-Kyung Cho 8
Abstract
A 21-year-old man was admitted to our hospital with recurrent bilateral pneumothorax and hemoptysis. Three years earlier, he underwent coil embolization due to a subarachnoid hemorrhage caused by an intracerebral aneurysm rupture. Two months after the coil embolization, he underwent an emergent total colectomy due to a massive infarction of the colon. One year after the colectomy, he started to have recurrent hemoptysis, and a few months later, multiple episodes of bilateral pneumothorax that required a chest tube placement began to occur. Notably, he had a history of easy bruising. He was taking Depakote and aspirin to prevent seizure and thromboembolic complications, respectively, both of which he began taking after the coil embolization. He denied the use of any illicit drugs. The histories of his parents and sister were not remarkable.
Figure 2. A-D, Histopathologic findings of the resected lung tissue. Whole-slide scan of the biopsied specimen showing multifocal parenchymal organizing hematomas with peripheral fibrosis (A); Focal neutrophilic and lymphocytic vasculitis involving the small pulmonary artery (red arrow) (H&E, x100) (B); Alveoli filled with erythrocytes, suggesting a fresh hemorrhage (red arrow) and hemosiderin-laden macrophages, suggesting an old hemorrhage (blue arrow) (C) (H&E, x100); Intra-alveolar fibrotic nodules with ossification (black arrows) (H&E, x40) (D).
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