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      Fatal rupture of pulmonary artery pseudoaneurysm after thoracic radiation therapy against lung squamous cell carcinoma: A case report and literature review

      case-report

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          Abstract

          Pulmonary artery pseudoaneurysm is a rare but fatal condition. It has been associated with lung cancer, abscesses, and radiation therapy. Identification in patients with hemoptysis is critical, and timely interventional therapy is warranted.

          Abstract

          Pulmonary artery pseudoaneurysm is a rare but fatal condition. It has been associated with lung cancer, abscesses, and radiation therapy. Identification in patients with hemoptysis is critical, and timely interventional therapy is warranted.

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          Most cited references27

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          Understanding radiation-induced vascular disease.

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            Sustained inflammation due to nuclear factor-kappa B activation in irradiated human arteries.

            The aim of this study was to investigate gene expression networks related to cardiovascular disease in radiated human arteries. Recent epidemiological studies have shown that radiotherapy is associated with cardiovascular disease years after treatment. However, the molecular mechanisms underlying late effects of radiation are poorly described. Arterial biopsies from radiated and nonradiated human conduit arteries, from the same patient, were simultaneously harvested during microvascular free tissue transfer for cancer-reconstruction in 13 patients, 4 to 500 weeks from radiation treatment. Radiated and nonradiated arteries were compared, with Affymetrix (Santa Clara, California) microarrays on a subset of the material to generate candidate genes. A Taqman (Applied Biosystems, Foster City, California) low-density array of 45 selected genes was designed for analysis of the whole material. Thirteen genes were synchronously expressed in all patients (p = 0.0015), including CCL8, CCL3, CXCL2, DUSP5, FGFR2, HMOX1, HOXA9, IL-6, MMP-1, PTX3, RDH10, SOD2, and TNFAIP3. A majority of differentially regulated genes related to the nuclear factor-kappa B (NF-kappaB) signaling pathway and were dysregulated even years after radiation. The NF-kappaB activation was confirmed by immunohistochemistry and immunofluorescence. In the present study, we found sustained inflammation due to NF-kappaB activation in human radiated arteries. The results are supported by previous in vitro findings suggesting that deoxyribonucleic acid injury, after radiation, activates NF-kappaB. We also suggest that HOXA9 might be involved in the regulation of NF-kappaB activation. The observed sustained inflammatory response can explain cardiovascular disease years after radiation. Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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              Aneurysms of the pulmonary artery.

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                Author and article information

                Contributors
                yfukuda.showa@gmail.com
                Journal
                Clin Case Rep
                Clin Case Rep
                10.1002/(ISSN)2050-0904
                CCR3
                Clinical Case Reports
                John Wiley and Sons Inc. (Hoboken )
                2050-0904
                07 December 2020
                February 2021
                : 9
                : 2 ( doiID: 10.1002/ccr3.v9.2 )
                : 737-741
                Affiliations
                [ 1 ] Department of Medicine Division of Respiratory Medicine and Allergology Showa University School of Medicine Tokyo Japan
                [ 2 ] Department of Pathology Showa University School of Medicine Tokyo Japan
                Author notes
                [*] [* ] Correspondence

                Yosuke Fukuda, Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, 1‐5‐8 Hatanodai, Shinagawa‐ku, Tokyo, Japan.

                Email: yfukuda.showa@ 123456gmail.com

                Author information
                https://orcid.org/0000-0002-7087-1595
                Article
                CCR33647
                10.1002/ccr3.3647
                7869342
                c177fdc1-5f37-4e32-8624-3b785ccde55b
                © 2020 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 18 May 2020
                : 14 November 2020
                : 24 November 2020
                Page count
                Figures: 5, Tables: 1, Pages: 5, Words: 2819
                Categories
                Case Report
                Case Reports
                Custom metadata
                2.0
                February 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.7 mode:remove_FC converted:08.02.2021

                hemoptysis,lung cancer,pulmonary artery pseudoaneurysm,radiation

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