A 90-year-old man visited our hospital with a chief problem of haemoptysis lasting for a month. He had a medical history of bladder cancer, including transurethral resection, 10 years previously. Chest and abdominal CT demonstrated a large cystic lesion with thin walls surrounded by infiltration and ground-glass opacities in the left lower lobe of the lung (figure 1A), with no findings of bladder cancer recurrence. Bronchoscopy detected a small amount of blood adhered to the lower left bronchus. Bronchial lavage fluid cultures did not identify bacterial, mycobacterial or fungal infections, and serological testing was negative for Aspergillus antigen. Subsequent bronchial artery embolisation failed to achieve haemostasis. Because the volume of haemoptysis was low, and the patient refused surgical resection of the cystic lesion to control the bleeding, careful observation was undertaken. Tranexamic acid was administered orally from the initial visit, and the haemoglobin level gradually decreased. Four intermittent blood transfusions were performed when the haemoglobin level dropped below 7.5 g/dL. Three months post initial visit, chest CT demonstrated a slight exacerbation of the infiltration around the cyst in the left lower lobe, with no findings of new cysts nor nodules in the lung fields. Subsequent periodic CT …

中文翻译：

---

转移性膀胱癌引起的多发性肺囊肿形成


一位 90 岁的老人来我院就诊，主要问题是持续一个月。他 10 年前有膀胱癌病史，包括经尿道切除术。胸部和腹部 CT 显示一个大的囊性病变，薄壁被浸润包围，左肺下叶有磨玻璃影（图 1A），没有发现膀胱癌复发。支气管镜检查检测到少量血液粘附在左下支气管上。支气管灌洗液培养未发现细菌、分枝杆菌或真菌感染，血清学检测曲霉菌抗原阴性。随后的支气管动脉栓塞术未能达到止血效果。由于咯血量低，且患者拒绝手术切除囊性病灶以控制出血，因此进行了仔细观察。从初次就诊开始口服氨甲环酸，血红蛋白水平逐渐下降。当血红蛋白水平降至 7.5 g/dL 以下时，进行了 4 次间歇性输血。初次就诊 3 个月后，胸部 CT 显示左下叶囊肿周围的浸润略有加重，肺野未发现新囊肿或结节。随后的周期性 CT 检查。