Background: Pulmonary arteriovenous malformations (PAVMs) are lesions in the vasculature that allow blood to bypass the capillary system, flowing from arteries directly into veins.
Case: Patient is a 50 years old male, with recurrent episodes of hemoptysis was initially treated as a case of pneumonia and PTB. CT scan with contrast and CT angiogram revealed AV malformation.
Histopathologic Findings: The specimen showed lung tissue exhibiting areas of varisized thin and partially thick vascular channels lined by endothelial cells surrounded by extensive intraalveolar hemorrhage and focal areas of atelectasis. It was seen in close proximity to a bronchus and accompanying medium-sized arteries, predominantly extending to the pleural lining.
Discussion: The definitive diagnosis is established by means of direct imaging study such as a CT scan with contrast, pulmonary angiogram and currently by CT angiogram. Our case presented with pneumonia, later developed hemoptysis and was confirmed with PAVM by CT scan and CT angiogram, and underwent right middle lobectomy. Other treatment options are embolization and lung transplantation.
Conclusion: The rarity of cases and the variability of presentation posed a great challenge. Its rarity should alert clinicians to include PAVM's in the differential diagnosis of patients with pneumonia and hemoptysis.