What happened, in summary

A man in his early 50s was found to have a pulmonary nodule during a physical examination. CT suggested malignancy, and he underwent a wedge resection of the right upper lobe. Frozen-section pathology confirmed invasive adenocarcinoma, so surgery was extended to a right upper lobectomy with lymph-node dissection. He recovered well and went home 5 days later.

Fifteen days after discharge, he suddenly coughed up a large amount of blood. Imaging showed a major right-sided pleural fluid collection, and drainage produced about 1 liter of blood. Emergency re-exploration of the chest did not identify an active bleeding point. He recovered, but 13 days after that second operation he developed another episode of coughing up blood with severe chest and back pain.

Repeat imaging again showed blood collecting near the bronchial stump. Bronchoscopy did not find an active airway bleeding site. Angiography finally revealed a tortuous bronchial artery with a pseudoaneurysm. The artery was embolized, completely stopping blood flow to the abnormal vessel.

During 6 months of follow-up after embolization, he had no further discomfort.