Southwest Journal of Pulmonary and Critical Care (Nov 2015)

Medical image of the week: athersclerotic aneurysm of great vessels

  • Jaffer F ,
  • Pepito DL

DOI
https://doi.org/10.13175/swjpcc104-15
Journal volume & issue
Vol. 11, no. 5
pp. 231 – 232

Abstract

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No abstract available. Article truncated at 150 words. A 60 year-old man with a 33 pack-year history of tobacco abuse, presented with difficulty speaking and voice change for several weeks. His review of systems was positive for fatigue, night sweats and weight loss. Physical exam of the oropharynx with flexible laryngoscopy demonstrated immobile bilateral true and false vocal cords fixed in the para-median position without laryngeal lesions. Concern for intra-thoracic process with recurrent laryngeal nerve involvement, a computed tomography (CT) of the chest and thoracic vessels demonstrated unusual appearing arteries with multiple penetrating atherosclerotic ulcers versus saccular aneurysms scattered throughout the aorta and its major branches (Figures 1 and 2). A magnetic resonance imaging (MRI) with contrast, demonstrated multiple foci of saccular outpouchings involving the arch vessels distal to their origins with the largest dilatation measuring 26 x 25 mm in the case of proximal innominate (Figure 3). Although imaging lacked resolution, it was specialist opinion that the ...

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