A case of massive haemoptysis

Description

A 77-year-old female never-smoker presented with massive haemoptysis. Admission plain chest radiograph was normal.

She was haemodynamically stable on presentation but the following morning she had a further large-volume haemoptysis (>500 mL), resulting in respiratory arrest. Following resuscitation, haemoglobin fell from 94 to 66 g/dL. CT angiogram was performed (figure 1).

Figure 1

Sagittal CT angiogram, performed once the patient was stabilised.

She had previously been investigated for small volume haemoptysis and left upper lobe mass-like consolidation, which had fully resolved following a course of antibiotics. Recent bronchoscopy was normal, with no pathological organisms. There was no evidence of malignancy or connective tissue disease, and there was no additional past medical history. CT imaging had been reviewed at a thoracic oncology multi-disciplinary meeting and the previous episode was attributed to non-specific infection.

Question

What is the diagnosis (see figure 1)?

(A) Pulmonary artery...

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