CASE 115 Published on 30.07.2000
0

Atherosclerotic aneurysm of the thoracic aorta

Section

Cardiovascular

Case Type

Clinical Cases

Authors

E. Bassetti, I. Carbone, C. Catalano

Connected authors
Patient

87 years, male

Categories
No Area of Interest ; Imaging Technique CT, MR
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Clinical History
An 88 years old man with a past history of hypertension. A chest X Ray showed a thoracic mass that had been revealed an aortic thoracic aneurysm by a CT angiography. The patient is doing well.
Imaging Findings
An 88 years old man. He had a past history of hypertension (150/95) without any other incident of note. Last November he underwent a chest X Ray before surgery. The X Ray showed a buldging of the left hilum. A CT angiography of the chest revealed an atherosclerotic sacciform aneurysm of the thoracic aorta. The vascular surgeon decided not to operate and the patient is following by our institution every 3 months. At the moment the patient is doing well.
Discussion
Many are the causes for the etiology of thoracic aortic aneurysm: Atherosclerosis, cystic medial degeneration, myxomatous degeneration, dissection, infection, trauma and post stenotic dilatation. The incidence of thoracic aortic aneurysm increases with age. They could be symptomatic, but often a routine chest film reveals an asymptomatic thoracic aneurysm. Actually, by using CT or MR angiography there is a diagnosis accuracy of almost 100%.
Differential Diagnosis List
Atherosclerotic sacciform aneurysm of the thoracic aorta
Final Diagnosis
Atherosclerotic sacciform aneurysm of the thoracic aorta
Case information
URL: https://eurorad.org/case/115
DOI: 10.1594/EURORAD/CASE.115
ISSN: 1563-4086
Figure 1

Chest X-Ray PA view

Chest X-Ray PA view
The image shows the presence of a round opacity of 4.5 cm of diameter in the iuxtailar region, without the evidence of the “silouette sign”, demonstrating the anterior position of the expansive formation. The mass has some periferal calcifications.
Figure 2

Chest X-Ray. Lateral view

Chest X-Ray. Lateral view
The lateral radiogram confirms the anterior position of the mass, localized near the anterior portion of the aortic arch.
Figure 3

Spiral CT images after the administration of contrast medium.

Spiral CT images after the administration of contrast medium.
Presence of a sacciform aneurysm of the thoracic aorta (5 cm x 4 cm), that originates in the external profile of the aortic arch with a large parietal thrombos. The exam confirms the presence of calcifications.
Spiral CT images after the administration of contrast medium.
Presence of a sacciform aneurysm of the thoracic aorta (5 cm x 4 cm), that originates in the external profile of the aortic arch with a large parietal thrombos. The exam confirms the presence of calcifications.
Spiral CT images after the administration of contrast medium.
Presence of a sacciform aneurysm of the thoracic aorta (5 cm x 4 cm), that originates in the external profile of the aortic arch with a large parietal thrombos. The exam confirms the presence of calcifications.
Spiral CT images after the administration of contrast medium.
Presence of a sacciform aneurysm of the thoracic aorta (5 cm x 4 cm), that originates in the external profile of the aortic arch with a large parietal thrombos. The exam confirms the presence of calcifications.