A Case of Pulmonary Arteriovenous Malformations Requiring Surgical Resection due to the Migration of Two Coils into A Single Lesion with Mycobacterium Avium Complex Infection after Coil Embolization

Akinaga Iijima; Masayuki Nakayama; Toshimi Kawahata; Mizuho Saito; Tomohiro Kikuchi; Atsushi Kihara; Makoto Maemondo

doi:10.2169/internalmedicine.4227-24

A Case of Pulmonary Arteriovenous Malformations Requiring Surgical Resection due to the Migration of Two Coils into A Single Lesion with Mycobacterium Avium Complex Infection after Coil Embolization

Intern Med. 2024 Dec 12. doi: 10.2169/internalmedicine.4227-24. Online ahead of print.

Authors

Akinaga Iijima¹, Masayuki Nakayama¹, Toshimi Kawahata¹, Mizuho Saito¹, Tomohiro Kikuchi², Atsushi Kihara³, Makoto Maemondo¹

Affiliations

¹ Division of Pulmonary Medicine, Department of Medicine, Jichi Medial University, Japan.
² Department of Radiology, School of Medicine, Jichi Medical University, Japan.
³ Department of Pathology, Jichi Medical University, Japan.

PMID: 39662916
DOI: 10.2169/internalmedicine.4227-24

Abstract

A 21-year-old male with hereditary hemorrhagic telangiectasia underwent coil embolization for three pulmonary arteriovenous malformations (right S⁶c, right S¹⁰a, and left S⁶b). Three years after coil embolization, coil migration was observed in the right S⁶c and S¹⁰a, and a cavitary lesion developed between the two coils. Four years after embolization, the two coil lesions were found to have merged within the cavity. Right lower lobectomy was performed for severe recurrent hemoptysis. A histological examination revealed a granuloma with caseous necrosis related to Mycobacterium avium complex (MAC) infection around the cavity. The patient did not exhibit hemoptysis or MAC recurrence after resection.

Keywords: Mycobacterium avium complex; Pulmonary arteriovenous malformations; coil embolization; coil migration; hemoptysis.