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05 - Lung: Aneurysm of pulmonary artery

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Rodin Number: 35
E Number: 175
Donor: Osler
Date: 1883
Size (H x W cm): 12.5 x 11

The specimen consists of two fragments of lung. The larger contains a 5 cm cavity consistent with tuberculosis; within it, is a 3 cm sac-like structure consistent with a pulmonary artery aneurysm (long arrow (A)). The smaller lung fragment also contains what appears to be an aneurysm, which is discontinuous in its lower portion (short arrow).

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Comment

According to the descriptive card, the patient was a 21 year-old man who died “from exhaustion” following hemoptysis (coughing up blood). (Additional details given by Osler in his autopsy protocol 710 are lost). During Osler's time, pulmonary artery aneurysms (Rasmussen aneurysms) were well known to arise at the edge of tuberculous cavities as a result of weakening of their wall by the inflammatory reaction to the tubercle bacillus. Extension of the inflammation sometimes led to the vessel's rupture causing massive bleeding into the lung and death, as in this case.

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