[Successful surgical ligation and transection of racemose hemangioma of bronchial artery].

We report two cases of bilateral racemose hemangioma in patients with hemoptysis. Case 1 was a 62-year-old woman who visited a local clinic complaining of hemoptysis. Bronchoscopy revealed multiple pulsating tumorous lesions and she was referred to our department. Chest Multidetector CT (MDCT) disclosed bilateral enlarged and convoluted, abnormal bronchial arteries and primary racemose hemangioma was diagnosed. Bronchial artery embolization was selected, but not conducted because of concern regarding the arteriovenous shunt and escape into the greater circulation. In combination with thoracoscopic mini-thoracotomy, ligation and separation of the bronchial artery were performed. Case 2 was a 68-year-old man who was transferred to our department with a chief complaint of hemoptysis. MDCT revealed bilateral bronchiectasis and a convoluted and enlarged, abnormal bronchial artery along the mediastinum. He was diagnosed as having secondary racemose hemangioma. First, bronchial artery embolization was conducted, but hemostasis was difficult, thus surgical ligation was conducted. In both cases, MDCT was effective for diagnosis and surgical ligation is very important as a therapeutic option for racemose hemangioma.

[A case of endobronchial mucormycosis with peculiar bronchoscopic findings].

Small cell lung cancer was diagnosed in a 54-year-old man in 1997. He had received 5 cycles of systemic chemotherapy and thoracic irradiation since 1997, and a favorable response had been achieved. In August 2001, pro-GRP was again elevated, and he was readmitted. Bronchoscopic findings revealed a white dendritic endobronchial mass on a cheese-like plug obstructing the left upper bronchus division. Numerous mucor hyphe and cancer cells were detected by transbronchial biopsy, and a fungal culture disclosed mucor. Although no antifungal drug was administered, the bronchial lesion disappeared after removal with biopsy forceps and 2 cycles of systemic anticancer chemotherapy. Endobronchial involvement of mucormycosis is rare and this case is unique because of the peculiar bronchoscopic finding with the endobronchial lesion.