Idiopathic pulmonary artery aneurysm: Digital subtraction pulmonary angiography grossly underestimates the size of the aneurysm

Pulmonary artery aneurysm is a rare disease entity. The majority of cases are associated with congenital cardiovascular diseases, infection, and trauma; idiopathic pulmonary artery aneurysm is extremely rare. Although conventional and digital subtraction pulmonary angiography remains as the imaging modality of choice for the pulmonary vessels, it is invasive and sometimes may be inaccurate. With the advent of spiral computed tomographic angiography (CTA), pulmonary artery aneurysm can be diagnosed noninvasively and accurately. We report a case of a 68-year-old man with idiopathic pulmonary artery aneurysm of the descending branch of right pulmonary artery where the true caliber of the aneurysm was significantly underestimated in the digital subtraction pulmonary angiography. The literatures of this rare condition are reviewed with the emphasis on the application of CTA in this disease.