A case of tuberculous thoracic aortitis with massive hemoptysis resulting from rupture of involved aorta into lung.

it is generally accepted that tuberculous lesions are rarely found in the wall of the aorta. Wettland and Scott’ (1956) reported a case of tuberculous false aneurysm of the aorta with rupture into the bronchus. According to their study, tuberculous aortic perforation into the respiraLory tract had only occurred in four previously published cases. Prior’ (1955) also reported a case with tuberculous periaortitis from caseous [ymphadenitis resulting in rupture of the aorta into the left main bronchus. Such a case has never been reported in Japanese literature. The present report is of a case of tuberculous thoracic aortitis. The patient died of massive hemoptysis which resulted from the rupture of involved aorta into the right lung. Case: F.T., a married woman, 28 years old. History: She had been quite well and tuberculin cutaneous test had been negative until she married in 1949 when she was 21 years old. She had pleuritis and endometritis tuberculosa at the age of 22 years. After treatment with streptomycin and para-aminosalyciic acid for about two years, she gradually recovered. However, endometritis tuberculosa relapsed when she was 25. Chest x-ray film at that time revealed no tuberculous lesion in the lung. Since then, under treatment with antituberculosis chemotherapy, she remained well until July 3, 1956, when she complained of sudden severe pain in the lower abdomen. A diagnosis of acute appendicitis was made by a surgeon and appendectomy was performed on the same date. In the excised appendix, slight inflammation was found. After the operation, continuous fever developed and her body temperature rose to 40#{176}C. on July 14. Since liver abscess was suspected, laparotomy was performed again by the